Nakai Makoto, Tazawa Toshiyuki, Wajima Naoki, Muroya Takahiro, Mikami Katsuya, Hakamada Kenichi
Dept. of Surgery, Hirosaki National Hospital.
Gan To Kagaku Ryoho. 2016 Nov;43(12):1839-1841.
The patient underwent robot-assisted total gastrectomy for an early gastric cancer. Thirty-four months later, he was admitted to another hospital because of abdominal discomfort. Computed tomography scans showed a giant solid mass approximately 13 cm in diameter in the lower abdomen. We performed a resection of the tumor; operative findings showed a giant solid tumor, without adhesion, in the mesentery of the jejunum. The tumor did not involve other parts of the small intestine. The resected tumor had a smooth surface with an elastic hard consistency. Pathological examination revealed that the tumor was immunohistochemically positive for a-SMA and b-catenin and negative for S-100, CD34, and c-kit. The tumor was diagnosed as a mesenteric fibromatosis. The patient did not show any incidence of recurrence for five months after resection. Mesenteric fibromatosis is a very rare condition and has been reported in association with Gardner's syndrome, abdominal traumas such as surgery and injury, and with pregnancy. This report describes a case of mesenteric fibromatosis after robotassisted laparoscopic surgery.
该患者因早期胃癌接受了机器人辅助全胃切除术。34个月后，他因腹部不适入住另一家医院。计算机断层扫描显示下腹部有一个直径约13厘米的巨大实性肿块。我们对肿瘤进行了切除；手术所见显示在空肠系膜中有一个巨大的实性肿瘤，无粘连。肿瘤未累及小肠的其他部位。切除的肿瘤表面光滑，质地硬且有弹性。病理检查显示，肿瘤免疫组化结果为α -平滑肌肌动蛋白（α-SMA）和β-连环蛋白阳性，而S-100、CD34和干细胞生长因子受体（c-kit）阴性。该肿瘤被诊断为肠系膜纤维瘤病。患者切除术后五个月未出现任何复发情况。肠系膜纤维瘤病是一种非常罕见的疾病，据报道与加德纳综合征、腹部手术和损伤等创伤以及妊娠有关。本报告描述了一例机器人辅助腹腔镜手术后发生肠系膜纤维瘤病的病例。
