Department of Surgery, Saitama Medical Center, Jichi Medical University, Shimotsuke, Japan.
Department of Surgery, Jichi Medical University, Shimotsuke, Japan.
Asian J Endosc Surg. 2020 Jul;13(3):426-430. doi: 10.1111/ases.12742. Epub 2019 Aug 7.
Desmoid tumors are monoclonal fibroblastic proliferations arising from soft tissue classified as intra-abdominal, extra-abdominal and abdominal wall types. We present a patient with an intra-abdominal desmoid tumor diagnosed 20 months after laparoscopic resection of rectal cancer. A 70-year-old woman with hematochezia was diagnosed with advanced rectal cancer. Preoperative chemoradiotherapy followed by laparoscopic low anterior resection was performed. During follow-up, a nodular soft-tissue density measuring 28 mm was detected in the presacral region. Metastasis from rectal cancer was diagnosed and four courses of chemotherapy were given, including capecitabine, oxaliplatin and bevacizumab. Computed tomography scan showed that the mass slightly decreased in size and surgical resection was performed. Histopathological examination revealed a proliferation of spindle-shaped cells and collagenous stroma diagnosed as a desmoid tumor. This report highlights the possibility of a desmoid tumor in the differential diagnosis of an intra-abdominal mass found during follow-up after resection of colorectal cancer including following laparoscopic resection.
腹外型、腹内型和腹壁型的纤维母细胞单克隆性增生，即硬纤维瘤，是一种软组织肿瘤。我们报告了一例腹腔镜直肠癌切除术后 20 个月诊断为腹内型硬纤维瘤的患者。一位 70 岁女性因血便被诊断为晚期直肠癌。术前行放化疗，后行腹腔镜低位前切除术。随访期间，在前骶骨区发现一结节状软组织密度影，大小为 28mm。诊断为直肠癌转移，给予卡培他滨、奥沙利铂和贝伐珠单抗四疗程化疗。CT 扫描显示肿块大小略有缩小，行手术切除。组织病理学检查显示梭形细胞和胶原基质增生，诊断为硬纤维瘤。该报告强调了在结直肠癌切除术后随访中发现的腹内肿块的鉴别诊断中，包括腹腔镜切除术后，硬纤维瘤的可能性。
