記述言語：英語   掲載種別：研究論文（学術雑誌）  

A peritoneal loose body (PLB) is a tissue completely separated from other intraperitoneal organs. It is rare and usually found incidentally during laparotomy, examination, or autopsy. It is usually located free in the peritoneal cavity and does not exist in the extraperitoneal space. It is generally thought to originate from the epiploic appendices released into the abdominal cavity following ischemic necrosis. We report a case of a giant PLB outside the peritoneal cavity, adjacent to the rectovesical excavation, inan asymptomatic 83-year-old man who underwent evaluation for cholecystolithiasis, preoperatively. Computed tomography revealed a mass with well-defined margins in the rectovesical excavation, consisting of a calcified core and peripheral soft tissue measuring 60 mm in diameter; it did not seem to invade adjacent organs. Although there were no symptoms or tumor growth over time, for a definitive diagnosis, we scheduled a laparoscopic extraction. On laparoscopic exploration, a white oval mass was found in the rectovesical excavation; there was no invasion of adjacent organs. We diagnosed the patient with a giant PLB.Postoperative recovery was uneventful. Most PLBs are asymptomatic and do not require surgery except when symptomatic, large in size, or suspicious for malignancy. The PLB is rarely extraperitoneal and usually freely mobile; however, in our patient, it was fixed and outside the abdominal cavity, near the rectovesical fossa. Although it could not be diagnosed preoperatively as being extra-peritoneal, it showed the typical imaging findings of PLB; thus, it was possible to remove the mass laparoscopically without bowel resection.

DOI： 10.1272/jnms.JNMS.2023_90-302

PubMed

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記述言語：日本語   出版者・発行元：(一社)日本門脈圧亢進症学会  

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記述言語：日本語   出版者・発行元：日本臨床外科学会  

症例は80歳,女性.胸部痛,嚥下困難を主訴に来院.上部消化管内視鏡で胸部上部から中部に隆起性腫瘍を認め,生検の病理組織検査で食道類基底細胞癌と診断された.胸部CTで,全周性の食道壁肥厚と腫瘍部近傍のリンパ節腫大を認め,cT3N1M0,cStageIIIと診断した.術前5-FU(600mg/m2,day1-5),Nedaplatin(45mg/m2,day1)併用化学療法を選択し,2コースを施行した.腫瘍の著明な縮小を認め,抗腫瘍効果はpartial response(CT-cT2N0M0 cStageII)でダウンステージが得られたと判断した.術前化学療法から約4週間後に,腹臥位胸腔鏡下食道切除術,腹腔鏡下胃管作成術,胸骨後経路にて頸部食道胃管吻合術を施行した.切除標本の病理組織検査で,元来腫瘤が存在した食道病変部位には腫瘍細胞を認めず,脈管侵襲・リンパ節転移も認めなかったため,化学療法の効果判定はGrade 3と診断した.5-FU/Nedaplatin併用化学療法は進行食道類基底細胞癌に対する術前化学療法レジメンの選択肢になり得る.(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2020&ichushi_jid=J03156&link_issn=&doc_id=20200713170012&doc_link_id=10.3919%2Fjjsa.81.1090&url=https%3A%2F%2Fdoi.org%2F10.3919%2Fjjsa.81.1090&type=J-STAGE&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00007_3.gif

記述言語：日本語   出版者・発行元：日本臨床外科学会  

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記述言語：日本語   出版者・発行元：(一社)日本大腸肛門病学会  

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記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

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記述言語：日本語   出版者・発行元：(NPO)日本食道学会  

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記述言語：日本語   出版者・発行元：(一社)日本消化器外科学会  

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