遺残ガーゼによる異物肉芽腫（ガーゼオーマ）を術前に診断し、腹腔鏡下で切除した１例

抄録

　A 57-year-old woman was admitted to our hospital with a pelvic mass and a left ovarian tumor. Twenty-one years ago, she had surgery for torsion of the right ovarian teratoma with salpingo-oophorectomy and appendectomy. Two years ago, a pelvic mass was found on magnetic resonance imaging (MRI), which was suspected to be a foreign body granuloma, but she complained of no symptoms, so she was instructed to follow up. However, a left ovarian tumor was additionally found during her annual medical checkup and she was referred to our hospital.

　Detailed ultrasonography, computed tomography (CT), and MRI revealed a tumor with calcification which was formed around a threaded matrix, and a left ovarian tumor with bilocular cysts. We diagnosed her with gauzeoma, a foreign body granuloma, and ovarian cystadenomas. Because there was a concern that the ovarian cyst would grow, we performed laparoscopic surgery to remove the tumor. When the left ovary was excised, we observed the sigmoid colon covering a mass in a curly manner. With the advice of a gastrointestinal surgeon, we detached the sigmoid colon from the tumor without damaging it and removed the tumor. The surgery took 130 minutes. The postoperative course was going well, and the final diagnosis was mucinous cystadenoma, mature cystic teratoma of the left ovary, and foreign body granuloma of the pelvis.

　This case of foreign body granuloma was almost asymptomatic for 21 years, and it was possible to make a preoperative diagnosis by CT and MRI. We were able to detach the sigmoid colon from the granuloma and remove it in a minimally invasive manner without any complications.