後腹膜Paragangliomaの1例

Abstract

26歳男性。患者は左側腹部の腫瘤を主訴とした。受診時, 左側腹部に小児頭大の腫瘤が触知され, 腹部CTおよびMRIにて後腹膜の神経原性腫瘍が疑われた。後腹膜腫瘍摘出術を施行したところ, 病理組織学的に後腹膜発生の非機能性Paragangliomaと診断され, 術後9ヵ月が経過した現在, 再発・転移はみられず, 経過は良好である。

Paragangliomas are rare neuroendocrine tumors that arise from hyperplastic paraganglionic cells and occur in or near the ganglia of the autonomic nervous system. Paragangliomas are classed as either functional or nonfunctional based on production of catecholamines. We report a case of retroperitoneal nonfunctional paraganglioma, which was successfully resected. A 26-year-old man presented with complaints of a mass palpable in his left lateral region. Blood and urine studies, including catecholamines, were within normal limits. Computed tomography and magnetic resonance imaging showed a solid cystic mass in the left retroperitoneal space without any distant metastasis. On exploration, there was an encapsulated, vascular mass 10 cm in diameter. There was no pedicle and no connection of the tumor to the abdominal or retroperitoneal organs. Complete excision of the tumor was performed smoothly. The postoperative period was uneventful. Histological findings were of paraganglioma, and there was no surgical margin. The patient did not receive any further treatment. Nine months after surgery, there were no signs of tumor recurrence.