A case of retroperitoneal bronchogenic cyst treated by laparoscopic surgery

Abstract

We describe herein a rare case of a retroperitoneal bronchogenic cyst successfully treated by laparoscopic surgery. A 39-year-old man with low-grade fever was referred to our hospital because of suspicion of an adrenal tumor. Abdominal computerized tomography (CT) and ultrasonography revealed a homogenous solid mass, 35 x 30 mm in diameter, in the left suprarenal region. Laboratory studies showed that the levels of adrenal hormones were normal except for the white blood cell count of 9, 700/microL and C-reactive protein of 1.7 mg/dl. We diagnosed it as a non-functioning adrenocortical adenoma or an adrenal cyst. However, one year later he underwent laparoscopic surgery because the mass had gradually increased by 10 mm and the low-grade fever persisted. Pathological evaluation of the surgical specimens established the diagnosis of retroperitoneal bronchogenic cyst. The low-grade fever disappeared after the surgery.

症例は39歳の男性。微熱精査中に後腹膜に腫瘤を指摘され, 当院を受診となった。腹部CT, 腹部超音波断層法において左副腎近傍に35mm大の均一な充実性腫瘍が認められた。血液生化学検査ではWBC9, 700/μL, CRP1.7mg/dlと軽度の炎症所見を認めたが, 内分泌学的検査では血中, 尿中カテコールアミンおよびアルドステロン, コルチゾールともに基準値範囲内であった。炎症所見が軽度なこと, 内分泌学的にも過剰なホルモン産生は確認されなかったため, 経過観察を行っていたが1年後の腹部CTでは約10mmの増大また微熱も持続していた。発熱の原因が後腹膜腫瘤である可能性も否定できないため, 腹腔鏡下に後腹膜腫瘍の摘除を行った。病理組織学的に腫瘍は気管支原性嚢胞であった。(著者抄録)