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第56回・2018年・横浜
 

術後40年後に後腹膜腫瘍の形態で再発した卵巣成人顆粒膜細胞腫の1例

演題番号 : P30-6

[筆頭演者]
演者)坂野 慎哉:1 
[共同演者]
今井 寿:1、松井 聡:1、今井 健晴:1、棚橋 利行:1、加藤 充純:1、田中 善宏:1、松橋 延壽:1、高橋 孝夫:1、山口 和也:1、二村 学:1、吉田 和弘:1

1:岐阜大学・腫瘍外科

 

Adult-type granulosa cell tumor of the ovary (GCT) is a relatively rare borderline ovarian malignant tumor and the tumor is characterized by a long natural history and late recurrence capacity. We report a case of recurrent GCT presenting as a retroperitoneal tumor 40 years after surgery. A 71-year-old woman consulted her local doctor complaining acute right back pain. CT showed a retroperitoneal mass, and she was referred to our hospital for further examinations. Forty years earlier, she had undergone a right ovarian tumor resection, but the details about its histopathology was unclear. The blood examination indicated a high inflammatory reaction, and the tumor markers were within normal range. Contrast-enhanced CT showed a retroperitoneal tumor 7 cm in diameter with inflammation and intratumoral hemorrhage. The tumor was located in the caudal side of the duodenum and inferior vena cava was severely compressed by the tumor. A left ovarian cyst was also detected. Gastro-duodenoscopy showed the reddening of duodenal mucosa and endoscopic ultrasonography (EUS) showed a low echoic heterogeneous tumor, and Ewing sarcoma family of tumors was suspected by EUS-guided fine-needle aspiration in immunohistochemistry. PET-CT showed weak accumulation to the tumor and there were no other accumulations. On the diagnosis of localized retroperitoneal tumor, surgical resection of the retroperitoneal tumor and left oophorectomy was performed. Microscopically, the tumor was diagnosed as a GCT and the left ovarian tumor was a non-malignant serous cystadenoma. It was suggested that the retroperitoneal tumor was the recurrence of the right ovarian tumor resected 40 years earlier, and adjuvant chemotherapy was started. In summary, long-term follow-up is essential considering the slow growing nature of GCT.

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手法別:手術療法

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