後腹膜気管支原性嚢胞の1例

Abstract

59歳男性.患者は2年前の健康診断時の腹部超音波断層検査で, 左後腹膜腔に長径6cmの嚢胞性腫瘤を指摘されたが, 無症状のため経過観察されていた.しかし今回, 腫瘤の増大に伴い高血圧と尿中カテコラミンの軽度高値がみられたため, 精査加療を目的に著者らの施設へ紹介となった.所見では, 腹部CTおよびMRIで, 左副腎・横隔膜間に径7×3.5×3cmで, 高密度の内容液を含むダンベル型の嚢胞性腫瘤が認められた.内分泌活性を有する嚢胞性副腎腫瘍の疑いもあり開腹術にて摘除したものの, 病理組織診断では後腹膜腔では稀な気管支原性嚢胞であった

A 59-year-old hypertensive man was referred to our hospital with a retroperitoneal cystic tumor, measuring 6 cm in diameter that was detected by an ultrasound examination during routine check-up 2 years before coming to our department. During the 2-year follow-up, the cystic tumor gradually increased in size. The patient also became hypertensive with slightly elevated urine levels of noradrenaline and dopamine, while the plasma catecholamines and their metabolites in the urine were within the normal range. Computed tomographic scanning and magnetic resonance imaging revealed a dumbbell-shaped retroperitoneal cyst with dense fluid, measuring 7 x 3.5 x 3 cm in diameter, in the left supra-adrenal and sub-diaphragmatic regions. He underwent extirpation of the cystic tumor with suspicion of adrenal endocrine cystic tumor. The histopathological diagnosis was a bronchogenic cyst, which is an extremely rare developmental anomaly in the retroperitoneal space. We herein report this rare case of retroperitoneal bronchogenic cyst and present a brief review of the previously reported 30 Japanese cases.