Kimura Masaki, Kato Hiroki, Sekino Seishiro, Ishida Narihiro, Murase Katsutoshi, Shimabukuro Katsuya, Sekino Takafumi, Doi Kiyoshi, Matsuo Masayuki
Department of General and Cardiothoracic Surgery, Graduate School of Medicine, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan.
Department of Radiology, Graduate School of Medicine, Gifu University, Gifu, Japan.
Surg Case Rep. 2018 Jan 18;4(1):7. doi: 10.1186/s40792-018-0417-4.
We report a case of a giant retroperitoneal calcifying fibrous tumor (CFT) treated by radical tumor resection combined with right hepatectomy and reconstruction of the inferior vena cava (IVC) and bilateral renal veins. Only three case reports of CFT arising in the retroperitoneum have been reported until today.
In a 19-year-old female patient, computed tomography (CT) images showed a well-demarcated expansile lesion around the IVC accompanied by focal calcification, whereas the IVC that was circumferentially surrounded by the lesion was dilated due to the desmoplastic reaction. On magnetic resonance imaging (MRI), the lesion demonstrated heterogeneous hypointensity on T2-weighted images. Delayed enhancement was observed on dynamic contrast-enhanced CT and MRI. F-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT images showed increased FDG uptake [maximum standardized uptake values (SUVmax), early image 7.28; delayed image 7.40]. On operative examination, because the tumor adhered to the liver parenchyma, the right Glisson capsule, and the origin of bilateral renal veins, radical tumor resection combined with right hepatectomy and reconstruction of the IVC and bilateral renal veins was performed.
Radical tumor resection was successfully and appropriately performed for a young patient with a giant retroperitoneal CFT with a view to achieving complete venous reconstruction and safe surgical margins for a potentially malignant tumor.
我们报告一例巨大腹膜后钙化性纤维瘤（CFT），采用肿瘤根治性切除联合右肝切除术及下腔静脉（IVC）和双侧肾静脉重建进行治疗。截至目前，仅报道了3例起源于腹膜后的CFT病例报告。
一名19岁女性患者，计算机断层扫描（CT）图像显示IVC周围有一个边界清晰的膨胀性病变，伴有局灶性钙化，而被病变周向包绕的IVC因促纤维组织增生反应而扩张。在磁共振成像（MRI）上，病变在T2加权图像上表现为不均匀低信号。动态对比增强CT和MRI上观察到延迟强化。氟代脱氧葡萄糖（FDG）正电子发射断层扫描（PET）/CT图像显示FDG摄取增加[最大标准化摄取值（SUVmax），早期图像为7.28；延迟图像为7.40]。手术检查时，由于肿瘤与肝实质、右Glisson包膜及双侧肾静脉起始部粘连，遂行肿瘤根治性切除联合右肝切除术及IVC和双侧肾静脉重建。
对于一名患有巨大腹膜后CFT的年轻患者，成功且恰当地实施了根治性肿瘤切除术，以期实现完全静脉重建并为潜在恶性肿瘤获得安全手术切缘。
