Miyata Kazushi, Fukaya Masahide, Nagino Masato
Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
Surg Case Rep. 2017 Dec;3(1):54. doi: 10.1186/s40792-017-0330-2. Epub 2017 Apr 20.
Intra-abdominal desmoid tumors, particularly those derived from the stomach, are rare. Such tumors are associated with a history of familial adenomatous polyposis (FAP), trauma, or surgical procedures in general. In addition, spontaneous shrinking of an intra-abdominal desmoid tumor is rarer. And desmoid tumors most commonly arise during the fourth decade of life.
A 17-year-old boy with lower abdominal pain was diagnosed with a gastrointestinal stromal tumor (GIST) or a hematoma at a local hospital. He had no history of FAP, trauma, or previous surgery. Abdominal computed tomography (CT) was performed for observational purposes three times over a 9-month period. The tumor gradually decreased in size over time; however, the tumor did not shrink sufficiently to be diagnosed as a hematoma. Because there was a high possibility of a GIST from the stomach, he underwent laparotomy. Operative findings revealed that the tumor was a hard mass firmly attached to both the greater curvature of the stomach and the inferior pole of the spleen. Pathologically, the tumor was diagnosed as a desmoid tumor derived from the stomach.
For a young boy without a history of FAP, trauma, or surgical procedures, it is difficult to define an intra-abdominal tumor near the stomach as a desmoid tumor. In such cases, surgical resection is recommended for a definitive diagnosis.
腹腔内硬纤维瘤，尤其是起源于胃的硬纤维瘤较为罕见。这类肿瘤通常与家族性腺瘤性息肉病（FAP）病史、创伤或外科手术有关。此外，腹腔内硬纤维瘤自发缩小更为罕见。硬纤维瘤最常见于生命的第四个十年。
一名17岁下腹痛男孩在当地医院被诊断为胃肠道间质瘤（GIST）或血肿。他没有FAP病史、创伤史或既往手术史。在9个月内进行了3次腹部计算机断层扫描（CT）以作观察。随着时间推移，肿瘤逐渐缩小；然而，肿瘤缩小程度不足以被诊断为血肿。由于高度怀疑是胃来源的GIST，他接受了剖腹手术。手术发现肿瘤是一个坚硬肿块，牢固附着于胃大弯和脾下极。病理诊断为起源于胃的硬纤维瘤。
对于没有FAP病史、创伤史或外科手术史的年轻男孩，很难将胃附近的腹腔内肿瘤定义为硬纤维瘤。在这种情况下，建议进行手术切除以明确诊断。
