Nickerson Terry P, Fahy Aodhnait S, Bingener Juliane
Department of Surgery, Mayo Clinic, Rochester, MN, United States.
Department of Surgery and Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, United States.
Int J Surg Case Rep. 2015;15:50-3. doi: 10.1016/j.ijscr.2015.07.024. Epub 2015 Jul 31.
Hemangiopericytoma (HPC) is a rare mesenchymal tumor derived from capillary and postcapillary pericytes that often has an indolent course and occasionally presents with abdominal metastasis.
Twenty-three years after the initial resection of an intracranial HPC located in the right frontoparietal region and left lateral ventricle, a 63-year-old man experienced dull abdominal pain and early satiety and had a palpable epigastric mass. Computed tomography indicated a suspected metastasis of HPC to the left upper abdomen. On laparoscopic exploration, the tumor was found in the falciform ligament and was excised laparoscopically per request of the patient. He had a fast recovery and experienced good relief of his pain and satiety. The patient had 2 additional metastases at his 12-month follow-up, both in the right retroperitoneum, and he again underwent laparoscopic resection. At his next annual follow-up, new metastases were identified in his liver, small-bowel mesentery, and peritoneal surface, prompting a trial of systemic chemotherapy. Because of progress of a left lower abdominal preperitoneal metastasis on follow-up at 3 years, the patient underwent a further successful laparoscopic exploration. Postoperatively, systemic chemotherapy was maintained.
We report the recurrent laparoscopic resection of peritoneal metastases of primary intracranial HPC with good symptom control and fast recovery. Both the patient and the referring physician requested a minimally invasive surgical approach.
Laparoscopic resection is a feasible treatment strategy for intraperitoneal metastases and is effective in symptom palliation.
血管外皮细胞瘤（HPC）是一种罕见的间叶性肿瘤，起源于毛细血管和毛细血管后周细胞，通常病程进展缓慢，偶尔会出现腹部转移。
一名63岁男性在首次切除位于右额顶叶区域和左侧脑室的颅内HPC 23年后，出现腹部隐痛和早饱感，上腹部可触及肿块。计算机断层扫描显示疑似HPC转移至左上腹。在腹腔镜探查中，发现肿瘤位于镰状韧带，应患者要求进行了腹腔镜切除。他恢复迅速，疼痛和早饱感明显缓解。患者在12个月随访时又出现了2处转移，均在右腹膜后，再次接受了腹腔镜切除。在次年的年度随访中，发现肝脏、小肠系膜和腹膜表面出现新的转移灶，遂进行全身化疗。由于3年随访时左下腹腹膜前转移灶进展，患者再次成功接受腹腔镜探查。术后维持全身化疗。
我们报告了原发性颅内HPC腹膜转移灶的复发性腹腔镜切除，症状控制良好且恢复迅速。患者和转诊医生均要求采用微创外科手术方法。
腹腔镜切除是治疗腹膜转移的一种可行策略，对缓解症状有效。
