Epithelial inclusion cystと思われる女子傍尿道嚢胞の1例

Abstract

症例は36歳女性で, 10年ほど前から外尿道口周囲の腫瘤に気付くも症状がなく放置していた.2年ほど前から腫瘤部の破裂, 白色液の排出, 疼痛がみられるようになり入院となった.画像所見等により傍尿道嚢胞の診断で嚢胞摘出術を施行した.嚢胞周囲剥離時に嚢胞壁を損傷し排膿がみられたが尿道との交通は認められなかった.摘出標本の病理組織学的所見では嚢胞壁は重層扁平上皮に被覆されており, 上皮下には軽度の単核細胞の浸潤が認められたが悪性所見はなく, epithelial inclusion cystと考えられた.術後経過は良好で術後9日目に退院し, その後再発はなく尿道狭窄や尿失禁といった合併症も認めていない.自験例は分娩等の後天的原因が推察されたが, 成人女性の傍尿道嚢胞は日本で43例目と考えられた

The patient was a 36-year-old woman with a chief complaint of pain of the urethral meatus. A cyst existed just below the urethral meatus. The paraurethral cyst was removed completely. Histologically, the cyst was lined by stratified squamous epithelium. According to the criteria proposed by Das, paraurethral cysts are classified into 4 groups: epithelial inclusion cysts, Mullarian cysts, Gartner duct cysts, Skene duct cysts. In this case, the cyst seemed to be an epithelial inclusion cyst. In the Japanese literature, paraurethral cysts have been incompletely classified from an etiological perspective. Differential diagnoses based on the histological findings of the cysts may be important to determine the etiology.