Lasseur Antoinette, Pasquer Arnaud, Feugier Patrick, Poncet Gilles
Department of Digestive and Oncological Surgery, Edouard Herriot University Hospital, Lyon Cedex 03, France.
Department of Digestive and Oncological Surgery, Edouard Herriot University Hospital, Lyon Cedex 03, France
J Surg Case Rep. 2016 May 5;2016(5):rjw070. doi: 10.1093/jscr/rjw070.
Desmoid tumors are rare potentially aggressive benign tumors. Various etiologies and recurrent factors have been presented and discussed. A case of an abdominal desmoid tumor with vascular mesenteric invasion in a 32-year-old female, over 2 years after pregnancy is presented. Pre-operative biopsy was not contributive, diagnosis was made after surgery. Resection required two vascular bypasses. Desmoid tumors appear frequently in women of child-bearing age (during or after pregnancy), hormonal signaling is probably involved, but pathways remain unknown. Multiple predictive factors of recurrence are discussed but not strongly identified due to underpowered studies: resection margins, age, sex, tumor's size and location. Recent development is in favor of a non-aggressive treatment such as 'wait and see' procedures. Without radical treatment, these tumors could generate bowel compression or perforation. Due to their location and high risk of complication, surgery is the most fitted option.
硬纤维瘤是一种罕见的具有潜在侵袭性的良性肿瘤。目前已经提出并讨论了各种病因和复发因素。本文报告了一例32岁女性腹部硬纤维瘤伴肠系膜血管侵犯的病例，该患者在怀孕2年多后发病。术前活检未提供有效诊断信息，术后才确诊。手术切除需要进行两次血管搭桥。硬纤维瘤常见于育龄女性（孕期或产后），可能涉及激素信号传导，但具体途径尚不清楚。虽然讨论了多种复发预测因素，但由于研究样本量不足，这些因素并未得到明确确认：切缘、年龄、性别、肿瘤大小和位置。目前的最新进展倾向于采取如“观察等待”等非激进的治疗方法。如果不进行根治性治疗，这些肿瘤可能会导致肠管受压或穿孔。鉴于其位置和高并发症风险，手术是最合适的选择。
