副腎Complicated cystとの鑑別が困難であったSchwannomaの1例

Abstract

62歳女.糖尿病で通院中, 右上腹部違和感を自覚した.超音波検査, CT検査で右上腹部に腫瘤を認めた.画像診断などから右副腎のcomplicated cystを最も考えたが, 内容が血腫であることが考えられ悪性腫瘍の合併も疑われたため, 腫瘍摘出術を施行した.病理組織学的所見から泡沫細胞を主体とするAntoni B型優位の嚢胞性良性神経鞘腫と診断した

A 62-year-old woman was hospitalized with complaints of right upper abdominal discomfort. Various imaging studies showed an extremely large suprarenal mass with solitary cystic formation. Partial adrenalectomy was successfully performed through the transperitoneal approach. The resected mass measured 12 x 10 x 10 cm and weighed 600 g. A pathological examination showed an Antoni-B predominant-type benign schwannoma containing a large volume of degenerative fluid. Our search of literature yielded few reports of solitary cystic schwannomas in the retroperitoneal cavity or throughout the body. This unusual cystic manifestation is thought to be a terminal stage of degeneration of a long-standing schwannoma.