Koyama Ryota, Maeda Yoshiaki, Minagawa Nozomi, Shinohara Toshiki
Department of Gastrointestinal Surgery, Hokkaido Cancer Center, Sapporo, Japan.
Case Rep Gastroenterol. 2020 Apr 21;14(1):197-205. doi: 10.1159/000506926. eCollection 2020 Jan-Apr.
We report the case of a 55-year-old man with a surgical history of distal gastrectomy with Roux-en-Y reconstruction performed 3 years prior to the present episode. During the follow-up, a newly developed, rapidly growing intraabdominal mass was detected in the mesentery of the small intestine. Although the patient had been asymptomatic, surgical resection was planned with the suspicion of malignancy, especially lymph node recurrence of the gastric cancer, owing to its rapid growth. Laparotomy showed that the tumor was located in the mesentery of the small intestine near the Roux-en-Y limb, and due to the involvement of the feeding vessels to the Roux-en-Y limb, the anastomotic site was resected en bloc with the tumor, and the whole Roux-en-Y limb was reconstructed. The histopathological finding was compatible with desmoid-type fibromatosis of the mesentery of the small intestine. Here we report our case and discuss the previously reported literature, especially related to gastric cancer.
我们报告一例55岁男性病例,该患者在本次发病前3年有远端胃切除术并Roux-en-Y重建的手术史。在随访期间,于小肠系膜内发现一个新出现的、迅速生长的腹腔内肿物。尽管患者一直无症状,但鉴于肿物生长迅速,怀疑为恶性,尤其是胃癌淋巴结复发,遂计划进行手术切除。剖腹探查显示肿瘤位于靠近Roux-en-Y肠袢的小肠系膜内,由于Roux-en-Y肠袢的供血血管受累,吻合部位与肿瘤一并整块切除,并对整个Roux-en-Y肠袢进行了重建。组织病理学检查结果符合小肠系膜硬纤维瘤病。在此我们报告该病例并讨论先前报道的文献,尤其是与胃癌相关的文献。