Department of Surgery, Kochi Medical School, Oko-cho, Nankoku, Kochi, 783-8505, Japan.
Department of Human Health and Medical Sciences, Kochi Medical School, Kochi, Japan.
Clin J Gastroenterol. 2021 Aug;14(4):1004-1007. doi: 10.1007/s12328-021-01404-8. Epub 2021 Mar 29.
We report a rare case of cystic lymphangioma of the greater omentum, which was treated by laparoscopic resection. A 61-year-old man was referred to our hospital for the treatment of a perigastric cystic lesion. Esophagogastroduodenoscopy revealed neither a mucosal lesion nor a submucosal tumor in the stomach. Abdominal contrast-enhanced computed tomography imaging showed a cystic lesion in the ventral side of the lower part of the stomach and no mass lesions in the liver. The patient underwent laparoscopic resection of the cystic lesion. The intraoperative observation confirmed that a well-defined cystic lesion was present wrapped in the greater omentum and located predominantly in the right side. Although the cystic lesion was located directly beside the right gastroepiploic artery and vein, excision of the cystic lesion along with the cuff of the omentum was performed without sacrificing the vessels. Macroscopic examination of the resected specimen showed an ovoid, cystic mass measuring 7.5 × 4.3 cm within the omentum. The pathological diagnosis was "cystic lymphangioma without malignant signs." Following surgery, the patient remained symptom-free without evidence of recurrence for 6 months. The laparoscopic approach, being minimally invasive, can be considered the most feasible approach for the resection of an abdominal cystic lymphangioma.
我们报告了一例罕见的大网膜囊状淋巴管瘤病例，该病例通过腹腔镜切除进行治疗。一名 61 岁男性因胃周囊性病变就诊于我院。食管胃十二指肠镜检查未发现胃黏膜病变或黏膜下肿瘤。腹部增强 CT 成像显示胃下部腹侧有囊性病变，肝脏无肿块病变。患者接受了腹腔镜囊性病变切除术。术中观察证实，一个界限清楚的囊性病变被大网膜包裹，主要位于右侧。尽管囊性病变直接位于胃网膜右动静脉旁边，但仍沿着网膜的边缘切除了囊性病变，而没有牺牲血管。切除标本的肉眼检查显示网膜内有一个 7.5×4.3cm 的卵圆形囊性肿块。病理诊断为“无恶性征象的囊性淋巴管瘤”。手术后，患者无任何症状，6 个月内无复发迹象。腹腔镜方法具有微创性，可被视为切除腹部囊性淋巴管瘤最可行的方法。
