内容紹介
Summary
A 69-year-old man with right upper quadrant abdominal pain and fever was referred to our hospital. He had a history of asbestosis exposure. Computed tomography(CT)revealed a mass at the right subhepatic space, and an antibiotic was administered after a diagnosis of an abdominal abscess. However, the patient did not respond to the treatment, and finally, exploratory laparoscopy was performed. A sheet of combined white nodules surrounding the right lobe of the liver was found, and the mass was continuous with the covering particles. Biopsy of the mass and immunohistochemical examination was performed. The resulting diagnosis was diffuse epithelial malignant peritoneal mesothelioma(MPM). Postoperative systematic chemotherapy of pemetrexed and cisplatin was administered. Laparoscopy was useful to evaluate the distribution of the MPM, which led to adequate therapeutic determination.
要旨
症例は69歳,男性。発熱と炎症反応を伴う右側腹部痛にて当院に受診となった。腹腔内膿瘍の診断で加療するも軽快乏しく,審査腹腔鏡を施行した。散在する白色結節性病変が肝右葉を取り囲むように発育し,腫瘤を形成していた。腫瘤生検・免疫染色を施行し上皮型悪性腹膜中皮腫の診断を得,pemetrexed(PEM)+cisplatin(CDDP)での全身化学療法の方針となった。悪性腹膜中皮腫の確定診断と治療方針決定には腹腔鏡が有用であった。
目次
A 69-year-old man with right upper quadrant abdominal pain and fever was referred to our hospital. He had a history of asbestosis exposure. Computed tomography(CT)revealed a mass at the right subhepatic space, and an antibiotic was administered after a diagnosis of an abdominal abscess. However, the patient did not respond to the treatment, and finally, exploratory laparoscopy was performed. A sheet of combined white nodules surrounding the right lobe of the liver was found, and the mass was continuous with the covering particles. Biopsy of the mass and immunohistochemical examination was performed. The resulting diagnosis was diffuse epithelial malignant peritoneal mesothelioma(MPM). Postoperative systematic chemotherapy of pemetrexed and cisplatin was administered. Laparoscopy was useful to evaluate the distribution of the MPM, which led to adequate therapeutic determination.
要旨
症例は69歳,男性。発熱と炎症反応を伴う右側腹部痛にて当院に受診となった。腹腔内膿瘍の診断で加療するも軽快乏しく,審査腹腔鏡を施行した。散在する白色結節性病変が肝右葉を取り囲むように発育し,腫瘤を形成していた。腫瘤生検・免疫染色を施行し上皮型悪性腹膜中皮腫の診断を得,pemetrexed(PEM)+cisplatin(CDDP)での全身化学療法の方針となった。悪性腹膜中皮腫の確定診断と治療方針決定には腹腔鏡が有用であった。