仙骨前部Dermoid cystの1例

概要

39歳男性.患者は下腹部痛を主訴に受診となった.WBC増多,軽度の肝障害,高血糖を認め,CTでは前立腺後部から直腸右側にかけて嚢胞状腫瘍を認め,頭側は精嚢腺,尾側は坐骨結節レベルまで存在し,一部に隔壁および壁肥厚を認めた.経直腸超音波では前立腺右側に内部均一な点状エコーの腫瘤を,MRIでは腫瘍内容はT1強調像でlow,T2強調像でiso~high densityであった.治療は抗生剤投与で下腹部痛は軽快し,WBCも改善した.更に経仙骨アプローチでは仙骨前部の嚢胞状腫瘍摘出術を施行し,迅速病理診断でdermoid cystと診断され,腫瘍のみの摘出を行っ髪成分が主体で,嚢胞壁は汗腺を含む角化扁平上皮,筋層構造で形成され,異型細胞は認めずdermoid cystと診断された.保存的治療で治癒し,現在外来経過観察中であるA case report of a presacral dermoid cyst in an adult. A 39-year-old man visited our hospital because of lower abdominal pain. A soft mass was palpable on the right side wall of rectum. Computed tomographic (CT) scan, transrectal ultrasonography and MR imaging showed presacral cystic tumor with a diameter of 10 cm. The tumor was resected by using a sacral approach. It contained muddy substance and hairs. Histopathological examination showed that the tumor wall was made of stratified squamous epithelium with skin appendage. Hence, it was diagnosed as a dermoid cyst. After operation, wound infection and dehiscence occurred, but it healed after conservative treatment. Complete excision of developmental cysts is advised because of possibility of malignancy and infection.

著者

桜井 正樹 松阪市民病院
有馬 公伸 三重大学医学部泌尿器科学教室

関連論文

▼もっと見る