Division of Thoracic Surgery, Department of Surgery, E-DA Hospital/I-Shou University, 1 Yi-Da Road, Jiau-shu Tsuen, Yan-chau Shiang, Kaohsiung 824, Taiwan, China.
World J Gastroenterol. 2010 Aug 21;16(31):3984-6. doi: 10.3748/wjg.v16.i31.3984.
Localized malignant pleural mesothelioma (LMPM) is a rare occurrence, and gastrointestinal intra-luminal metastases have not previously been reported. Herein, we report a patient with LMPM who presented with a local recurrence 10 mo after initial en bloc surgical resection. Abdominal computed tomography was performed for intractable, vague abdominal pain with episodic vomiting, which showed a "target sign" over the left lower quadrant. Laparotomy revealed several intra-luminal metastatic tumors in the small intestine and colon and a segmental resection of metastatic lesions was performed. Unfortunately, the patient died of sepsis despite successful surgical intervention. Though local recurrence is more frequent in LMPM, the possibility of distant metastasis should not be ignored in patients with non-specific abdominal pain.
局限性恶性胸膜间皮瘤(LMPM)较为罕见,且此前并未报道过胃肠道腔内转移。本文报道了 1 例局限性恶性胸膜间皮瘤患者,该患者在初始整块切除术后 10 个月局部复发,并出现难以缓解的、模糊的腹痛和间歇性呕吐。腹部 CT 显示左下腹呈“靶征”。剖腹探查显示小肠和结肠有多个腔内转移瘤,并进行了转移病灶的节段性切除。尽管手术干预成功,但患者仍因脓毒症死亡。尽管局限性恶性胸膜间皮瘤更容易局部复发,但对于出现非特异性腹痛的患者,不应忽视远处转移的可能性。