Kudoh Akitoshi, Tokuhisa Yoshihiro, Morita Katsuhiko, Hiraki Sakurao, Fukuda Shintarou, Eguchi Nobuo, Iwata Takako
Department of Surgery, Ube Central Hospital, Ube, Yamaguchi 755-0151, Japan.
Surg Today. 2005;35(7):594-7. doi: 10.1007/s00595-004-2966-3.
We report a rare case of a solitary primary paraganglioma arising in the mesentery, found in a 72-year-old woman who presented with abdominal pain and a palpable abdominal mass. This extra-abdominal paraganglioma developed from paraganglionic cells that travelled by vertebral migration from the root of the superior mesenteric artery. Extra-adrenal paraganglia extend anywhere from the neck down to the base of the pelvis. Ultrasonography, computed tomography (CT), and angiography showed a solid and cystic heterogeneously enhanced mass, which was fed by the superior mesenteric artery, without distant metastasis. Exploratory laparotomy revealed a large, dark, brownish-red mass in the mesentery of the ileum, which was distinct from the ileum. The mass consisted of peripherally solid areas with central hemorrhage and cystic degeneration. It was diagnosed as a paraganglioma histologically. The patient is free from recurrence of paraganglioma after 1 year of follow up. To our knowledge, this represents only the seventh case of a paraganglioma arising in the mesentery.
我们报告了一例罕见的肠系膜原发性孤立性副神经节瘤病例,该病例发生在一名72岁女性身上,她因腹痛和可触及的腹部肿块就诊。这种腹外副神经节瘤由副神经节细胞发展而来,这些细胞通过椎骨迁移从上肠系膜动脉根部游走至此。肾上腺外副神经节可延伸至从颈部到骨盆底部的任何部位。超声、计算机断层扫描(CT)和血管造影显示一个实性和囊性混合强化的肿块,由上肠系膜动脉供血,无远处转移。剖腹探查发现回肠系膜有一个大的、深色的、棕红色肿块,与回肠不同。肿块由周边实性区域和中央出血及囊性变组成。组织学诊断为副神经节瘤。随访1年后,患者未出现副神经节瘤复发。据我们所知,这是仅有的第七例发生在肠系膜的副神经节瘤病例。