腹腔鏡下に治療し得た巨大後腹膜腫瘍の１例

抄録

　We report a case of massive retroperitoneal tumor that had to be removed laparoscopically.

　The patient was a 53-year-old woman who was admitted to our hospital with the chief complaint of abdominal discomfort. Transvaginal ultrasonography revealed multiple uterine fibroids and a giant intra-abdominal tumor. Magnetic resonance imaging (MRI) showed a retroperitoneal mass on the left side of the pelvis and a suspected uterine fibroid with hydropic degeneration. After discussing the treatment options with the patient, we performed laparoscopic surgery for the removal of the retroperitoneal mass was planned due of the patient's desire for surgical treatment with the patient's consent. Intraabdominal examination revealed a large, discontinuous retroperitoneal tumor that grew in the retroperitoneum adjacent to the uterus. After total laparoscopic hysterectomy, the left broad membrane was stretched, and the retroperitoneal tumor was carefully dissected and removed through an en-bloc procedure. The operation took 179 minutes, and the intraoperative bleeding was mild. Permanent pathology of the resected specimen indicated hydropic degeneration of the tumor and intravascular invasion. Immunostaining showed that the samples were positive for desmin and smooth muscle actin, but negative for CD10; the Ki-67 index was ≤1%. Based on these observations, leiomyoma was diagnosed. The patient experienced no intraoperative complications. The postoperative course was also unremarkable, and the patient was discharged from the hospital on the third postoperative day. During the follow-up examination, the patient did not exhibit any symptoms or signs of recurrence.