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腹腔镜保留脾脏的远端胰腺切除术治疗胃胰病变处的实性囊性腹腔内硬纤维瘤:病例报告

Laparoscopic spleen-preserving distal pancreatectomy for a solid-cystic intraabdominal desmoid tumor at a gastro-pancreatic lesion: a case report.

作者信息

Sugimachi Keishi, Iguchi Tomohiro, Ohta Mitsuhiko, Mano Yohei, Hisano Terumasa, Yokoyama Ryohei, Taguchi Kenichi, Ikebe Masahiko, Morita Masaru, Toh Yasushi

机构信息

Department of Hepatobiliary-Pancreatic Surgery, National Hospital Organization Kyushu Cancer Center, 3-1-1 Notame, Minami-ku, Fukuoka, 811-1395, Japan.

Department of Gastroenterological Surgery, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan.

出版信息

BMC Surg. 2020 Feb 3;20(1):24. doi: 10.1186/s12893-020-0691-5.

Abstract

BACKGROUND

We report a case of an intraabdominal desmoid tumor that occurred at a gastro-pancreatic lesion with spontaneous cystic features, and present the successful laparoscopic resection of the tumor.

CASE PRESENTATION

A 20-mm retroperitoneal cystic mass with a solid component was found adjacent to the stomach and pancreatic body in a 52-year-old woman with no history of familial adenomatous polyposis. Laparoscopic spleen-preserving distal pancreatectomy with wedge resection of the stomach was performed, and complete resection was achieved without intraoperative and postoperative complications. Histopathological examination by immunohistochemistry enabled diagnosis of a desmoid tumor that had originated from the stomach and invaded the pancreatic parenchyma with a spontaneous cystic change. We herein report an extremely rare case of an intraabdominal desmoid tumor with a spontaneous cystic change.

CONCLUSION

Regardless of its rarity, desmoid tumor should be included in the preoperative differential diagnosis of a cystic intraabdominal mass, and laparoscopic function-preserving surgery may be an optimal treatment option.

摘要

背景

我们报告一例发生于胃胰病变处的具有自发囊性特征的腹腔内硬纤维瘤病例,并展示该肿瘤的成功腹腔镜切除术。

病例介绍

在一名无家族性腺瘤性息肉病病史的52岁女性中,发现一个20毫米的腹膜后囊性肿块,伴有实性成分,位于胃和胰体附近。实施了保留脾脏的腹腔镜远端胰腺切除术并楔形切除胃,实现了完整切除,术中及术后均无并发症。通过免疫组织化学进行的组织病理学检查确诊为起源于胃并侵犯胰腺实质且伴有自发囊性改变的硬纤维瘤。我们在此报告一例极为罕见的伴有自发囊性改变的腹腔内硬纤维瘤病例。

结论

尽管硬纤维瘤罕见,但在术前对腹腔内囊性肿块进行鉴别诊断时应考虑到,腹腔镜保留功能手术可能是最佳治疗选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d949/6998096/918ef9d69450/12893_2020_691_Fig1_HTML.jpg

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