臍部子宮内膜症の1例

Abstract

54歳女.子宮筋腫にて受診中, 臍部腫瘤を自覚したが放置し, 婦人科医に連絡せず, 増大してきたため外科を受診し, 尿膜管との関連を疑われた.入院時臍部皮下に弾性硬, やや不整な, 可動性不良の腫瘤を触れた.下腹部恥骨直上には弾性硬の手拳大腫瘤を触れた.腹部単純CTにて臍部皮下に22×20mmの境界一部不明瞭な腫瘤を認め, 腹膜との癒着が疑われた.また, 骨盤内には直径12cm大の子宮筋腫を認めた.以上より, 臍部腫瘍と診断し, 臍部腫瘤切除術を施行した.摘出標本は大きさ21×20mmの充実性で赤褐色を呈し, 割面は黄白色, 充実性で数mm大のcystic lesionを数箇所に認め, 淡黄色の内容液であった.術後経過は良好で退院した.病理組織学的に臍部子宮内膜症と診断した.術後5ヵ月を経過したが, 子宮内膜症の再発は認められない

A 54-year-old female was referred to us for a nodule under her umbilical region. The nodule had enlarged slowly and reached a size of 20 mm in diameter over the last 2 years. She had no symptoms and there was no oozing of blood or pain during menstruation. The nodule was removed under lumbar anesthesia. Histological examination of the resected nodule revealed an island of glandular tissue in the deep dermis, which was composed of a single layer of columnar cells, and was diagnosed as umbilical endometriosis. There was no associated lesion in the intrauterine or pelvic space. There has not been any evidence of recurrence five months postoperatively. On finding an umbilical mass in women, this rare disease must be considered.