Mizuno Mari, Kawaguchi Yoshiaki, Kawanishi Aya, Kawashima Yohei, Maruno Atsuko, Ogawa Masami, Tomioku Mifuji, Furukawa Daisuke, Nabeshima Kazuhito, Nakamura Kenji, Hirabayashi Kenichi, Mine Tetsuya
aDepartment of Gastroenterology, Tokai University School of Medicine, Isehara, Japan.
bDepartment of Surgery, Tokai University School of Medicine, Isehara, Japan.
Case Rep Oncol. 2017 Apr 4;10(1):301-307. doi: 10.1159/000468983. eCollection 2017 Jan-Apr.
A 45-year-old woman was found to have a pancreatic tumor by abdominal ultrasound performed for a medical check-up. Abdominal contrast-enhanced computed tomography showed a hypovascular tumor measuring 30 mm in diameter in the pancreatic tail. Endoscopic ultrasound-guided fine needle aspiration was performed. An extragastric growing gastrointestinal stromal tumor was thereby diagnosed preoperatively, and surgical resection was planned. Laparoscopic surgery was attempted but conversion to open surgery was necessitated by extensive adhesions, and distal pancreatectomy, splenectomy, and partial gastrectomy were performed. The histological diagnosis was an intra-abdominal desmoid tumor. A desmoid tumor is a fibrous soft tissue tumor arising in the fascia and musculoaponeurotic tissues. It usually occurs in the extremities and abdominal wall, and only rarely in the abdominal cavity. We experienced a case with an intra-abdominal desmoid tumor that was histologically diagnosed after laparotomy, which had been preoperatively diagnosed as an extragastric growing gastrointestinal stromal tumor. Although rare, desmoid tumors should be considered in the differential diagnosis of intra-abdominal tumors. Herein, we report this case with a literature review.
一名45岁女性在进行体检的腹部超声检查中发现胰腺肿瘤。腹部增强计算机断层扫描显示胰腺尾部有一个直径30毫米的低血运肿瘤。进行了内镜超声引导下细针穿刺活检。由此术前诊断为胃外生长型胃肠道间质瘤，并计划进行手术切除。尝试了腹腔镜手术，但因广泛粘连而不得不转为开放手术，遂行远端胰腺切除术、脾切除术和部分胃切除术。组织学诊断为腹腔内硬纤维瘤。硬纤维瘤是一种起源于筋膜和肌腱膜组织的纤维性软组织肿瘤。它通常发生在四肢和腹壁，很少发生在腹腔内。我们遇到一例腹腔内硬纤维瘤病例，经剖腹手术后进行了组织学诊断，该病例术前被诊断为胃外生长型胃肠道间质瘤。尽管罕见，但在腹腔内肿瘤的鉴别诊断中应考虑硬纤维瘤。在此，我们报告该病例并进行文献复习。
