乙状结肠带蒂平滑肌瘤的内镜下切除

Endoscopic Removal of Pedunculated Leiomyoma of the Sigmoid Colon.

作者信息

Sato Harunobu, Mizuno Yoshihisa, Tsukamoto Tetsuya, Ichikawa Tomoaki, Kotani Yoshihito, Honda Katsuyuki, Kuroda Makoto

机构信息

Department of Surgery, Rokuwa Hospital, Inazawa, Japan ; Department of Surgery, Fujita Health University, School of Medicine, Toyoake, Japan.

Department of Surgery, Rokuwa Hospital, Inazawa, Japan.

出版信息

Viszeralmedizin. 2014 Dec;30(6):427-9. doi: 10.1159/000368791.

DOI:10.1159/000368791

PMID:26288610

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4513831/

Abstract

BACKGROUND

The large bowel is a rare site for leiomyomas. Furthermore, a colonic pedunculated leiomyoma is very rare. Complete endoscopic removal of a colonic leiomyoma can be problematic because of its submucosal origin.

CASE REPORT

We report a colonic pedunculated leiomyoma that was removed by endoscopic polypectomy without complications. A 74-year-old man was referred to our hospital because of constipation. Colonoscopy demonstrated a 1-cm pedunculated polyp that was connected to a minute stalk within the sigmoid colon. It was removed by snare polypectomy. Histopathological examination demonstrated normal mucosa overlying a well-circumscribed proliferation of eosinophilic spindle cells arising in association with the muscularis mucosae. Immunohistological findings were positive for desmin and smooth muscle actin. The polyp was diagnosed as a leiomyoma. More than 9 months later, the patient remains well, with no further symptoms.

CONCLUSION

For small, pedunculated leiomyomas, endoscopic snare polypectomy is thought to be a useful approach for both treatment and diagnosis.

摘要

背景

大肠是平滑肌瘤的罕见发病部位。此外，结肠带蒂平滑肌瘤极为罕见。由于结肠平滑肌瘤起源于黏膜下层，完整的内镜下切除可能存在问题。

病例报告

我们报告一例通过内镜下息肉切除术成功切除且无并发症的结肠带蒂平滑肌瘤。一名74岁男性因便秘前来我院就诊。结肠镜检查发现一个1厘米的带蒂息肉，与乙状结肠内的细蒂相连。通过圈套器息肉切除术将其切除。组织病理学检查显示，息肉表面黏膜正常，其下为与黏膜肌层相关的边界清晰的嗜酸性梭形细胞增生。免疫组织学检查结果显示结蛋白和平滑肌肌动蛋白呈阳性。该息肉被诊断为平滑肌瘤。9个多月后，患者情况良好，未出现进一步症状。