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乙状结肠炎性肌纤维母细胞瘤:肠梗阻的罕见病因。

Inflammatory Myofibroblastic Tumor of Sigmoid Colon: Unusual Cause of Intestinal Obstruction.

作者信息

Chinnakkulam Kandhasamy Sakthivel, Sundaramurthi Sudharsanan, Vijayakumar Chellappa, Goneppanavar Mangala, Nelamangala Ramakrishnaiah Vishnu Prasad

机构信息

Surgery, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, IND.

Pathology, Mahatma Gandhi Medical College and Research Institute, Puducherry, IND.

出版信息

Cureus. 2020 Nov 30;12(11):e11809. doi: 10.7759/cureus.11809.

Abstract

Inflammatory myofibroblastic tumors (IMFTs) are rare solid mesenchymal tumors frequently noted in children and young adults. It is characterized by variable clinicopathological and etiopathogenetic features. They are commonly reported in the lungs and occurrence in the colon is extremely rare. Here, we report a case of IMFT in the sigmoid colon confirmed histopathologically after surgical resection. A 40-year-old lady presented with abdominal pain, vomiting, and constipation for four days. On abdominal examination, there was tenderness in the left iliac fossa region with localized guarding. Contrast-enhanced computed tomography (CECT) showed a sigmoid colonic mass lesion with few enlarged perilesional lymph nodes. Colonoscopy demonstrated circumferential ulceration with irregular margin associated with luminal narrowing noted 55 cm from the anal verge and scope could not negotiate beyond, biopsies were taken. Later, the biopsy came as descriptive in nature. Hence, we proceeded for surgery and intra-operatively we have found there was circumferential thickening in the sigmoid colon for about size 8 cm of which was abutting the left lateral parietal wall. We have done sigmoid colon resection with adequate margins and postoperatively patient did well. Finally, the histopathology report suggested an IMFT sigmoid colon.

摘要

炎性肌纤维母细胞瘤(IMFTs)是罕见的实体间叶组织肿瘤,常见于儿童和年轻人。其具有多样的临床病理和病因发病学特征。它们通常在肺部被报道,而发生在结肠极为罕见。在此,我们报告一例经手术切除后经组织病理学确诊的乙状结肠IMFT病例。一名40岁女性因腹痛、呕吐和便秘4天就诊。腹部检查时,左髂窝区域有压痛并伴有局部肌紧张。增强计算机断层扫描(CECT)显示乙状结肠有一肿块病变,周围有少数肿大的淋巴结。结肠镜检查显示距肛缘55 cm处有边缘不规则的环形溃疡伴管腔狭窄,内镜无法通过,遂取活检。后来,活检结果为描述性。因此,我们进行了手术,术中发现乙状结肠有大约8 cm大小的环形增厚,与左侧顶壁相邻。我们进行了乙状结肠切除,切缘足够,术后患者恢复良好。最后,组织病理学报告提示为乙状结肠IMFT。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7bd6/7779172/3981f845fb76/cureus-0012-00000011809-i01.jpg

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