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患有冯·雷克林霍增氏病患者的腔静脉后肿块:病例报告

Retrocaval mass in patient with von Recklinghausen disease: case report.

作者信息

Cavallaro G, Crocetti D, Pedullà G, Giustini S, Letizia C, De Toma G

机构信息

Department of Medico-Surgical Sciences and Biotechnologies, "Sapienza " University of Rome, Italy.

出版信息

G Chir. 2012 Jan-Feb;33(1-2):26-30.

Abstract

Type I Neurofibromatosis (NF1) is an autosomal-dominant inheritable disorder, with an incidence of 1:3,000, and a prevalence of 1:4,000 to 5,000. Pathogenesis is based on mutations of the NF1 gene, a tumor suppressor gene encoding a cytoplasmic protein named neurofibromin that controls cellular proliferation. Patients affected by NF1 typically present with cutaneous neurofibromas, cafè au lait spots and eye involvement, but they can also be affected by various visceral tumors, such as neurofibromas (nodular or plexiform type), gastrointestinal stromal tumors or endocrine tumors, such as pheochromocytomas. Visceral neurofibromas are often asymptomatic but when growing in size they may present with pain, palpable abdominal mass, symptoms secondary to bowel obstruction or main vessels compression, and even gastrointestinal bleeding when mucosa or submucosa are involved. In these cases surgery becomes mandatory in order to remove all neoplastic tissue. The Authors describe a case of a young man affected by NF1 with associated retrocaval abdominal mass with compression and displacement of the inferior vena cava, thus requiring a complex surgical procedure.

摘要

I型神经纤维瘤病(NF1)是一种常染色体显性遗传性疾病,发病率为1:3000,患病率为1:4000至5000。其发病机制基于NF1基因的突变,该肿瘤抑制基因编码一种名为神经纤维瘤蛋白的细胞质蛋白,可控制细胞增殖。NF1患者通常表现为皮肤神经纤维瘤、咖啡斑和眼部受累,但也可能受到各种内脏肿瘤的影响,如神经纤维瘤(结节型或丛状型)、胃肠道间质瘤或内分泌肿瘤,如嗜铬细胞瘤。内脏神经纤维瘤通常无症状,但当它们增大时,可能会出现疼痛、可触及的腹部肿块、肠梗阻或主要血管受压继发的症状,当累及黏膜或黏膜下层时甚至会出现胃肠道出血。在这些情况下,为了切除所有肿瘤组织,手术成为必要手段。作者描述了一例受NF1影响的年轻男性病例,伴有腔后腹部肿块,压迫并移位下腔静脉,因此需要进行复杂的手术。

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