Canu Gian Luigi, Medas Fabio, Columbano Giulio, Gordini Luca, Saba Luca, Erdas Enrico, Calò Pietro Giorgio
Department of Surgical Sciences, "Policlinico Universitario Duilio Casula", University of Cagliari, 09042 Monserrato, Italy.
Department of Radiology, "Policlinico Universitario Duilio Casula", University of Cagliari, 09042 Monserrato, Italy.
Case Rep Surg. 2018 Aug 1;2018:4324986. doi: 10.1155/2018/4324986. eCollection 2018.
Benign multicystic peritoneal mesothelioma (BMPM) is a rare condition, more common in females of reproductive age, which arises from the peritoneal mesothelium. A 33-year-old male presented to our unit with abdominal pain and constipation. His past medical history included a previous unilateral nephrectomy for Wilms' tumor and the previous incidental finding of some intra-abdominal cystic formations at the level of the mesentery. After performing a CT scan, an exploratory laparotomy was done and a voluminous cystic mesenteric mass, composed of 3 confluent formations, was observed. Some other similar but significantly smaller lesions were found. An en bloc resection of the mesenteric mass together with the corresponding intestinal loops, an appendicectomy, and some peritoneal biopsies were performed. The postoperative period was complicated by a peritonitis due to dehiscence of the intestinal anastomosis, which required another operation, and a delayed return of normal bowel function, which was resolved through prokinetic therapy. Through histological examination, a BMPM was diagnosed. At 8 months of follow-up, the patient is free of symptoms. BMPM exact etiopathogenesis still remains uncertain. Given his high recurrence rate, a long-term follow-up is recommended.
良性多囊性腹膜间皮瘤(BMPM)是一种罕见疾病,在育龄女性中更为常见,起源于腹膜间皮。一名33岁男性因腹痛和便秘前来我院就诊。他既往病史包括因肾母细胞瘤行单侧肾切除术,以及之前偶然发现肠系膜水平有一些腹腔内囊性肿物。进行CT扫描后,实施了剖腹探查术,观察到一个巨大的囊性肠系膜肿物,由3个融合的肿物构成。还发现了一些其他类似但明显较小的病变。对肠系膜肿物连同相应肠袢进行了整块切除、阑尾切除术,并取了一些腹膜活检组织。术后出现并发症,因肠吻合口裂开导致腹膜炎,需要再次手术,且肠道功能恢复延迟,通过促动力治疗得以解决。经组织学检查,诊断为BMPM。随访8个月时,患者无症状。BMPM的确切病因仍不确定。鉴于其高复发率,建议进行长期随访。