腹膜偽粘液腫を来した尿膜管原発粘液囊胞腺腫の術後に 無再発15 年生存を得た1 例

A 58-year-old man complaining of lower abdominal distension came to our hospital. Abdominal CT showed massive ascites with partition wall in the abdominal cavity and a 13 cm-sized massive cystic tumor contiguous to the apex of the bladder in the abdominal cavity. The ascites collected by echo-guided puncture was gelatinous. We diagnosed this case as pseudomyxoma peritonei arising from mucinous cyst adenoma of the urachus and surgery was performed. Laparotomy revealed cystic tumor contiguous to the bladder and the navel, and massive yellow jelly-like mucinous materials with a total weight of 4,500 g scattered in the abdominal cavity. The urachal cystic tumor was resected and extensive peritoneum excision with multiple gelatinous materials was done. Then 100 mg of cisplatin was infused into the peritoneal cavity twice postoperatively from the abdominal port. The resected tumor was diagnosed mucinous cyst adenoma of the urachal origin from histopathology and perioperative findings generally. We performed adjuvant chemotherapy, and with no recurrence during over 15 years of follow-up. There are rare cases that obtained long-term survival by postoperative no recurrence with pseudomyxoma peritonei arising from mucinous cyst adenoma of the urachus.