内容紹介
Summary
Aggressive angiomyxoma is an uncommon mesenchymal tumor that mostly involves the pelvic and perineal regions in young women. We herein report an extremely rare case of aggressive angiomyxoma in a 75-year-old man. The patient had undergone follow-up for an intraductal papillary mucinous neoplasm. In September 2015, CT detected a tumor measuring 33 mm in diameter around the pelvis, and the tumor showed gradual increase in size. MRI revealed a relatively sharply marginated tumor with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. For treatment and diagnosis, we laparoscopically resected the tumor. Histopathologically, the specimen showed spindle tumor cells within a myxoid background and vascular structures. The tumor was diagnosed as aggressive angiomyxoma, and surgical margins were negative for tumor cells. The patient is currently doing well without any signs of recurrence as of 18 months postoperatively.
要旨
侵襲性血管粘液腫は粘液産生と血管増生を伴う紡錘形の希少な腫瘍であり,その大部分は若年女性に発生する。今回われわれは,高齢男性に発生した侵襲性血管粘液腫を経験したので報告する。症例は75歳,男性。膵管内乳頭粘液性腫瘍で経過観察されていた。2015年9月のCT検査で骨盤内に長径33 mmの腫瘍性病変を認め,その後も増大傾向であったため精査加療目的で当科に紹介となった。腫瘍はMRI検査にてT1低信号,T2高信号な比較的境界明瞭な病変であり,粘液型脂肪肉腫などを疑い,診断と治療目的で腹腔鏡下切除を行った。切除検体の組織検査で豊富な粘液や血管新生を伴う紡錘形腫瘍細胞の増殖を認め,侵襲性血管粘液腫の診断となった。術後は大きな合併症もなく第10病日で退院となり,現在18か月経過するも再発は認めていない。
目次
Aggressive angiomyxoma is an uncommon mesenchymal tumor that mostly involves the pelvic and perineal regions in young women. We herein report an extremely rare case of aggressive angiomyxoma in a 75-year-old man. The patient had undergone follow-up for an intraductal papillary mucinous neoplasm. In September 2015, CT detected a tumor measuring 33 mm in diameter around the pelvis, and the tumor showed gradual increase in size. MRI revealed a relatively sharply marginated tumor with low signal intensity on T1-weighted images and high signal intensity on T2-weighted images. For treatment and diagnosis, we laparoscopically resected the tumor. Histopathologically, the specimen showed spindle tumor cells within a myxoid background and vascular structures. The tumor was diagnosed as aggressive angiomyxoma, and surgical margins were negative for tumor cells. The patient is currently doing well without any signs of recurrence as of 18 months postoperatively.
要旨
侵襲性血管粘液腫は粘液産生と血管増生を伴う紡錘形の希少な腫瘍であり,その大部分は若年女性に発生する。今回われわれは,高齢男性に発生した侵襲性血管粘液腫を経験したので報告する。症例は75歳,男性。膵管内乳頭粘液性腫瘍で経過観察されていた。2015年9月のCT検査で骨盤内に長径33 mmの腫瘍性病変を認め,その後も増大傾向であったため精査加療目的で当科に紹介となった。腫瘍はMRI検査にてT1低信号,T2高信号な比較的境界明瞭な病変であり,粘液型脂肪肉腫などを疑い,診断と治療目的で腹腔鏡下切除を行った。切除検体の組織検査で豊富な粘液や血管新生を伴う紡錘形腫瘍細胞の増殖を認め,侵襲性血管粘液腫の診断となった。術後は大きな合併症もなく第10病日で退院となり,現在18か月経過するも再発は認めていない。