放射線治療が著効を示した後腹膜腔Hemangiopericytomaの1例

Abstract

A 48-year-old woman came to our hospital with complaint of macroscopic hematuria and left lower abdominal pain, on January, 27, 1982. She complained of lower abdominal oppressive pain, but no abdominal tumor was palpated on physical examination. Vaginal examination revealed a stony hard and nodular tumor which was not movable, and as large as a man's fist, on the left side of uterine cervix. IVP revealed left nonfunctioning kidney. Cystoscopy revealed no abnormal finding but left ureteral catheterization could not be done. CTscan revealed intrapelvic homogenous mass which could not be identified from uterus. Pelvic angiography revealed an encasement of the left uterine artery, and moderate hypervascular tumor which deviated the obturatorius artery. Under the diagnosis of retroperitoneal tumor, operation was done on March, 8, 1982. The tumor existed in the retroperitoneal space, and was as large as a man's fist. It was not a movable mass, venous dilatation was found on its surface, and severe adhesion was found between the lateral side of the tumor and the left external iliac artery. So only biopsy was done. Histopathological diagnosis of the specimen was hemangiopericytoma. She received postoperative radiation therapy with total dose 5, 000rad in 5 weeks. Now about 2 years have passed, vaginal examination revealed no tumor, and CTscan revealed diminishment of the tumor. Generally radiotherapy is not considered to be effective for hemangiopericytoma, but sometimes it is. Thus preoperative vascular embolization with surgical resection and postoperative radiotherapy or chemotherapy are considered to be necessary for successful treatment of hemangiopericytoma.