Ono Hitomi, Hori Kensuke, Tashima Lena, Tsuruta Tomohiko, Nakatsuka Shin-Ichi, Ito Kimihiko
Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Japan.
Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Japan.
Int J Surg Case Rep. 2018;47:30-33. doi: 10.1016/j.ijscr.2018.03.039. Epub 2018 Mar 29.
Desmoid-type fibromatosis represents a rare, benign, soft tissue tumour that is locally invasive with high recurrence potential.
We encountered a case of retroperitoneal desmoid-type fibromatosis in a 45-year-old woman who presented with chief complaints of stomach ache and vomiting. She underwent total abdominal hysterectomy and left salpingo-oophorectomy due to uterine myoma and a paroophoritic cyst at 42 years of age. Abdominal computed tomography showed a 5-cm left retroperitoneal tumour and severe hydronephrosis of the left kidney. Multiple imaging studies failed to provide a definitive diagnosis. Therefore, we performed tumour resection, right salpingo-oophorectomy, ureterectomy, and ureterocystostomy. The tumour surrounded the left ureter and adhered to the left internal/external iliac artery, rectum, bladder, and the edge of the vagina. Histopathologic examination yielded a diagnosis of retroperitoneal desmoid-type fibromatosis. One month after the operation, transvaginal sonography showed a 2-cm mass in the pelvis. We suspected tumour recurrence and commenced pharmacotherapy with tranilast (300mg/day, three times per day). Four months after the operation, the mass disappeared.
There are minimal reports of postoperative intra-abdominal desmoid-type fibromatosis and preoperative diagnosis is difficult. To the best of our knowledge, there are no reported cases of desmoid-type fibromatosis that involved the ureter with severe hydronephrosis following a gynaecologic operation.
We experienced a case of retroperitoneal desmoid-type fibromatosis that involved a unilateral ureter after gynaecologic surgery.
韧带样型纤维瘤病是一种罕见的良性软组织肿瘤，具有局部侵袭性且复发潜力高。
我们遇到一名45岁女性，患有腹膜后韧带样型纤维瘤病，主要症状为胃痛和呕吐。她在42岁时因子宫肌瘤和卵巢旁囊肿接受了全腹子宫切除术和左侧输卵管卵巢切除术。腹部计算机断层扫描显示左侧腹膜后有一个5厘米的肿瘤，左肾严重肾积水。多项影像学检查未能提供明确诊断。因此，我们进行了肿瘤切除、右侧输卵管卵巢切除术、输尿管切除术和输尿管膀胱吻合术。肿瘤包绕左侧输尿管，并附着于左髂内/外动脉、直肠、膀胱和阴道边缘。组织病理学检查确诊为腹膜后韧带样型纤维瘤病。术后1个月，经阴道超声检查显示盆腔有一个2厘米的肿块。我们怀疑肿瘤复发，开始使用曲尼司特进行药物治疗（300毫克/天，每日三次）。术后4个月，肿块消失。
关于术后腹腔内韧带样型纤维瘤病的报道极少，术前诊断困难。据我们所知，尚无妇科手术后韧带样型纤维瘤病累及输尿管并导致严重肾积水的报道病例。
我们遇到一例妇科手术后腹膜后韧带样型纤维瘤病累及单侧输尿管的病例
