多発性嚢胞腎患者に発生し骨盤腔に進展した巨大な会陰部Epidermal cystの1例

Abstract

75歳男.約20年前より会陰部腫瘤に気付き, 無痛であった為放置していたが, 腫瘍の表面の糜爛から出血した為受診した.画像所見, 触診所見では診断ができず, 腫瘤を認めてからの経過も長く, 画像上も転移を疑わせる所見がないことから, 良性腫瘍の可能性が考えられた.高位砕石位, 経会陰的に腫瘤摘出術を施行した.最終的に会陰部の皮膚から発生したepidermal cystと診断した.術後経過は良好で, 排便・歩行等も問題なく, 1年後も再発を認めていない

A 75-year-old man with autosomal dominant polycystic kidney disease was admitted to our hospital with the chief complaint of a giant mass in the left side of the perineum that had gradually developed in size during the previous 20 years. Palpation revealed a neonatal head-sized cystic mass with no tenderness. Magnetic resonance imaging (MRI) demonstrated a well-circumscribed homogeneous mass extended to the dorsal side of the bladder. It was excised surgically without any injury of rectum or urinary tract. The resected specimen was 23 x 18 x 12 cm in size and 1.2 kg in weight. The pathological diagnosis was epidermal cyst. Cases with an epidermal cyst extending into the pelvic space are extremely rare with few cases having been reported in the world.