Ito Tetsuya, Chika Noriyasu, Yamamoto Azusa, Ogura Toshiro, Amano Kunihiko, Ishiguro Toru, Fukuchi Minoru, Kumagai Youichi, Ishibashi Keiichiro, Eguchi Hidetaka, Okazaki Yasushi, Mochiki Erito, Ishida Hideyuki
Dept. of Digestive Tract and General Surgery, Saitama Medical Center, Saitama Medical University.
Gan To Kagaku Ryoho. 2016 Nov;43(12):2316-2319.
A 44-year-old man with familial adenomatous polyposis underwent laparoscopic-assistedtotal proctocolectomy with ilealpouch anal anastomosis(IPAA). Computed tomography conducted 21 months after IPAA demonstrated bilateral hydronephrosis andan intra-abdominal mass with a maximal diameter of 22 cm, leading to a diagnosis of stage IV desmoid disease, according to the classification by Church and associates. Six courses of combination chemotherapy with doxorubicin plus dacarbazine were administered. Computed tomography after chemotherapy demonstrated marked shrinkage of the desmoidtumor with intraabdominal air andfluidcollection extending just below the skin of the ileostomy closure site. Stoollike fluidoverflowedspontaneously through the site of the ileostomy closure andthe abscess cavity was successfully drained. The patient was discharged 30 days after the start of drainage. The patient is doing well 10 months after the drainage without regrowth of the desmoid tumor, even though a cavity-like lesion encapsulatedby a thick wall remains.
一名患有家族性腺瘤性息肉病的44岁男性接受了腹腔镜辅助全直肠结肠切除术并进行回肠储袋肛管吻合术（IPAA）。IPAA术后21个月进行的计算机断层扫描显示双侧肾积水以及一个最大直径为22 cm的腹腔内肿块，根据Church及其同事的分类，诊断为IV期硬纤维瘤病。给予了六个疗程的阿霉素加达卡巴嗪联合化疗。化疗后的计算机断层扫描显示硬纤维瘤明显缩小，腹腔内有气体和液体聚集，延伸至回肠造口关闭部位皮肤下方。粪便样液体自回肠造口关闭部位自发溢出，脓肿腔成功引流。引流开始30天后患者出院。引流10个月后患者情况良好，硬纤维瘤未复发，尽管仍存在一个被厚壁包裹的腔样病变。
