腫瘍核出術を施行した骨盤内神経鞘腫の2例

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症例1:62歳男.腹部腫瘤に気付いて入院し,右下腹部に10cm大の腫瘤,右下肢知覚鈍麻があり,仙髄腔生検で得た腫瘍細胞はS100蛋白陽性であった.背部からの仙骨内腫瘍剔除に続いて経腹的に手術したところ,骨盤腔内に小児頭大腫瘍があり,総腸骨静脈,内外腸骨動脈と固着しており,腫瘍核出術を行った. 症例2:35歳女.左臀部痛と左下肢のしびれで受診し,開腹して径8cmの腫瘍が内外腸骨静脈と固着しており,被膜を残して腫瘍核出術を行った. 骨盤内Schwannomaで被膜と共に剔出した報告は日本で57例あり,被膜を残して腫瘍核出術を施行したのは自験例の2例のみであるが,2例とも再発の徴候はみられていないA 65-year-old man and a 35-year-old woman were diagnosed with intrapelvic tumors originating from the sacral nerves by computed tomographic (CT) scan, magnetic resonance imaging (MRI) and angiography. These tumors were tightly adhered to the iliac arteries and veins and could not be resected completely. Since the cryostat sections revealed benign schwannomas histopathologically, we enucleated the tumors without the pseudocapsules. All of the 57 intrapelvic schwannomas previously reported in Japan were resected with pseudocapsules. Both of our patients showed improvement of subjective symptoms, but should be followed up and examined for the presence of regrowth of tumors.