膀胱後部平滑筋腫の1例

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53歳女.尿閉を主訴として来院.1,200mlの残尿があり,双手診で下腹部腫瘤を認めたので入院した.尿蛋白3(+),SCCの軽度上昇(1.9ng/ml)があった.膀胱鏡では軽度の外方からの圧排所見のみであったが,排泄性腎盂造影で著明な圧排所見と骨盤底部の石灰化,CT, MRIでは膀胱後部に直径6cmの腫瘤を認めた.針生検では脂肪細胞様の細胞が得られ,α平滑筋アクチン,desmin染色等から膀胱後部平滑筋腫と診断し剔出した.摘出標本は7×7×6cm,重量250gで,粘液変性,嚢胞状変化,石灰化,硝子化を伴った平滑筋腫であった.膀胱後部平滑筋腫の報告は,日本でこれまでに18例のみであるWe report a case of retrovesical leiomyoma in a 53-year-old woman. In September, 1994, she visited our clinic with the chief complaint of urinary retention. Drip infusion pyelography (DIP), computed tomographic (CT) scan, and magnetic resonance imaging (MRI) revealed a large tumor behind the urinary bladder. Simple tumor excision was performed. The tumor, 7 x 7 x 6 cm in size and 250 g in weight, was histologically diagnosed as leiomyoma. This is the 18th case of retrovesical leiomyoma reported in the literature in Japan.