膀胱前腔に発生した異所性褐色細胞腫の1例

Paraganglioma, extra-adrenal pheochromocytomas, are relatively rare in adults, with most arising from para-aortic sympathetic and visceral organs, such as the bladder. Paraganglioma localized at the extravesical retroperitoneal pelvic cavity is extremely rare. We report a case of symptomatic perivesical pheochromocytoma in a 34-year-old man treated by surgical excision. Symptoms related to cathecolamine secretion ceased after surgery, and the patient has remained disease-free for 24 months.異所性褐色細胞腫は大人では比較的稀な疾患であり、そのほとんどは傍大動脈神経や膀胱などの内臓臓器に発生する。膀胱前腔に発生した褐色細胞腫はきわめて稀であり、文献報告例が5例のみである。今回、膀胱前腔に発生した褐色細胞腫に対して外科的治療を施行した1例を経験したので報告する。症例は34歳、男性で排尿時痛を主訴に当院を受診。前立腺超音波にて前立腺腹側に腫瘤を認めた。以前より高血圧、高血糖の既往があり、5年前に原因不明のノルエピネフリンとドーパミン高値を認めていたため、当院でもホルモン検査施行。血清ノルアドレナリン、血清ドーパミン、尿中ノルアドレナリン、尿中VMAの異常高値を認めた。また131I-MIBGシンチグラムでは膀胱前腔に異常集積を認め異所性褐色細胞腫と診断し、骨盤内腫瘤切除術を施行。術後、排尿時痛は改善し高血糖や高血圧も改善した。術後24ヵ月経過しているが現在再発は認めていない。(著者抄録

Risk Factors for Wheezing, Eczema and Rhinoconjunctivitis in the Previous 12 Months among Six-Year-Old Children in Himeji City, Japan: Food Allergy, Older Siblings, Day-Care Attendance and Parental Allergy History

Background: The aim of this study was to clarify whether some environmental and genetic factors (food allergy, older siblings, early day-care attendance and parents' allergy history) are related to the development of allergic symptoms (wheezing in the previous 12 months [WP], eczema symptoms in the previous 12 months [EP], and rhinoconjunctivitis symptoms in the previous 12 months [RP]) in Japanese children. Methods: Using the modified version of the International Study on Asthma and Allergies in Childhood (ISSAC) questionnaire, we studied the prevalence of WP, EP and RP among six-year-old children attending 72 primary schools throughout Himeji City, Japan, during the two years from 2005 to 2006. Results: Food allergy and parents' history of allergy showed a significant relationship with the prevalence of WP, EP and RP. Day-care attendance in the first two years of life and presence of older siblings showed a significant inverse relationship with the prevalence of RP. However, neither day-care attendance nor presence of older siblings was related to the development of W and ER. Conclusions: Among Japanese children, food allergy and parents' history of allergy are risk factors for WP, ES or RS. However, early day-care attendance and presence of older siblings might be protective factors against RS. Infections in early life may affect the prevalence of rhinoconjunctivitis in six-year-old children