Kimura Sho, Teranishi Futoshi, Katada Takeyasu, Koide Shuji, Shibata Takahiro, Nakai Nozomu, Matsuo Yoichi
Dept. of Surgery, Narita Memorial Hospital.
Gan To Kagaku Ryoho. 2023 Dec;50(13):1659-1661.
In August 2022, a 59-year-old female noted a mass in her umbilicus and sought evaluation at Toyokawa City Hospital. Abdominal computed tomography(CT)scan revealed a 1.6 cm mass in the umbilical region, ascites in the pelvis, and increased absorption in the omentum. Peritoneal dissemination of the carcinoma and Sister Mary Joseph's nodule due to an unknown primary tumor were suspected because no abnormalities were detected during upper and lower gastrointestinal endoscopy. She underwent an umbilical lumpectomy and diagnostic laparoscopy to establish a definitive diagnosis. The surgical findings included numerous white nodules throughout the abdominal cavity. The umbilical mass and omental white nodules were resected. A final diagnosis of epithelial peritoneal mesothelioma was made based on the histopathologic examination. In general, peritoneal mesothelioma has a poor prognosis, and early treatment is essential; however, making a timely definitive diagnosis is difficult. Peritoneal mesothelioma should be included in the differential diagnosis for a patient with unexplained ascites and abdominal pain. Diagnostic laparoscopy and biopsy will facilitate the establishment of a definitive diagnosis.
2022年8月，一名59岁女性发现脐部有肿物，遂前往丰川市医院求治。腹部计算机断层扫描（CT）显示脐部区域有一个1.6厘米的肿物，盆腔有腹水，大网膜吸收增加。由于上、下消化道内镜检查未发现异常，怀疑为原发性不明的癌性腹膜播散和玛丽·约瑟夫修女结节。她接受了脐部肿块切除术和诊断性腹腔镜检查以明确诊断。手术所见包括整个腹腔内有许多白色结节。切除了脐部肿物和大网膜白色结节。根据组织病理学检查最终诊断为上皮性腹膜间皮瘤。一般来说，腹膜间皮瘤预后较差，早期治疗至关重要；然而，及时做出明确诊断很困难。对于不明原因腹水和腹痛的患者，应将腹膜间皮瘤纳入鉴别诊断。诊断性腹腔镜检查和活检将有助于明确诊断。
