前立腺全摘除術後4ヵ月目に感染性リンパ嚢腫を発症した1例

Abstract

70歳, 限局性前立腺癌に対する前立腺全摘除術+限局的骨盤内リンパ節郭清術の約4ヵ月後に悪心, 嘔吐, 右下腹部痛, 発熱, 排尿困難等が出現した.画像所見や臨床経過から感染性リンパ嚢腫を疑って経皮的嚢胞穿刺術を行い, 嚢胞貯留液の生化学的検査・培養検査所見から同症と診断された.持続ドレナージ, 抗菌薬の局所投与, 硬化療法などを行い, リンパ嚢腫は消失した

Symptomatic lymphocele presented after pelvic lymphadenectomy for localized carcinoma of the prostate is a relatively rare complication. We treated a case of infected lymphocele presenting 4 months after a limited staging pelvic lymphadenectomy and a radical prostatectomy for adenocarcinoma of the prostate. The patient was a 70-year-old Japanese man having the chief complaint of fever, right lower abdominal pain, nausea and vomiting. Pelvic computed tomography showed a 14 cm cystic mass with a thick capsule on the right iliopsoas muscle. It was suspected to be an infected lymphocele. After percutaneous drainage, sclerotherapy (povidone iodine, minocycline and ethanol) and antibiotic drugs, the infected lymphocele was resolved.