Yamamoto Azusa, Matsuyama Takatoshi, Hatano Satoshi, Chika Noriyasu, Kumakura Masumi, Sugino Aoi, Ishikawa Hiroyasu, Ito Tetsuya, Kumagai Yoichi, Mochiki Erito, Masuda Wataru, Imada Hiroki, Momose Shuji, Isaka Takahiro, Ishida Hideyuki
Dept. of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University.
Gan To Kagaku Ryoho. 2022 Dec;49(13):1977-1979.
An 81-year-old female visited a local hospital with complaints of anal pain. A tumor was found on the right side of her anus, and the histopathological diagnosis was a non-epithelial malignant tumor. Therefore, the patient was referred to our hospital. Result of imaging inspection revealed that the tumor had invaded the lower rectum, but had not distantly metastasized. Based on the findings of another biopsy, the patient was diagnosed with a malignant peripheral nerve sheath tumor (MPNST). Robot-assisted abdominoperineal resection(D1)was performed, and the lesion was resected without any pathological remnants. During the postoperative period, the patient developed perineal wound infection. Subsequently, the patient was discharged from the hospital on postoperative day 10. At the 6-month postoperative follow-up, no recurrence was noted. Most MPNSTs occur in the limbs, trunk, and neck. MPNST in the primary gastrointestinal tract or in the vicinity of the gastrointestinal tract is relatively rare, and in principle, combined resection of the intestinal tract is required for surgical treatment. Here, we report a case of MPNST that occurred near the anus and infiltrated to the lower rectum and was completely resected by robot-assisted abdominoperineal resection.
一名81岁女性因肛门疼痛前往当地医院就诊。在其肛门右侧发现一个肿瘤，组织病理学诊断为非上皮性恶性肿瘤。因此，该患者被转诊至我院。影像学检查结果显示肿瘤已侵犯低位直肠，但无远处转移。根据另一次活检结果，患者被诊断为恶性外周神经鞘瘤（MPNST）。实施了机器人辅助腹会阴切除术（D1），病变切除后无任何病理残留。术后患者出现会阴伤口感染。随后，患者于术后第10天出院。术后6个月随访时，未发现复发。大多数MPNST发生于四肢、躯干和颈部。原发性胃肠道或胃肠道附近的MPNST相对少见，手术治疗原则上需要联合肠道切除。在此，我们报告一例发生于肛门附近并浸润至低位直肠的MPNST，经机器人辅助腹会阴切除术完全切除。
