Okada Takuma, Hirata Keiichiro, Tanaka Hiroto, Miyamoto Hironari, Tsujio Gen, Kurihara Shigeaki, Matsutani Shinji, Nagashima Daisuke, Hirakawa Toshiki, Iwauchi Takehiko, Morimoto Junya, Yamagata Shigehito, Uchima Yasutake, Takeuchi Kazuhiro
Dept. of Surgery, Fuchu Hospital.
Gan To Kagaku Ryoho. 2020 Dec;47(13):1836-1838.
Desmoid tumor is one kind of fibromatosis, and much occurs the abdominal wall and outside the abdominal wall. Intra- abdominal desmoid tumor is rare at about 8%. We experienced a case of intra-abdominal desmoid tumors occurring 4 years after open radical prostatectomy with some literature review. A 72-year-old man had undergone open radical prostatectomy for prostate cancer. Four years after that resection, multiple intra-abdominal tumors measuring 56 mm in maximum diameter was identified on follow-up computed tomography, and he was referred to our department for management. We performed laparotomy and investigation of the biopsy. Immunohistochemistry of the resected specimen indicated the tumor cells were positive for vimentin and β-catenin, and the diagnosis was desmoid. We performed partial resection of the small intestine and ileocecal resection. His postoperative course was uneventful and he was discharged on the 12th postoperative day. He has shown no sign of recurrence in the 4 months follow-up since surgery. In the past, an operation was the best treatment for intra-abdominal desmoid tumor. But it is reported that watchful waiting is also possible by the case which has no symptom and dysfunction in NCCN guidelines 2019. Further research is needed.
硬纤维瘤是一种纤维瘤病，多发生于腹壁和腹壁外。腹腔内硬纤维瘤罕见，发生率约为8%。我们报道了1例开放性根治性前列腺切除术后4年发生腹腔内硬纤维瘤的病例，并进行了文献复习。一名72岁男性因前列腺癌接受了开放性根治性前列腺切除术。切除术后4年，随访计算机断层扫描发现腹腔内多个最大直径为56 mm的肿瘤，遂转诊至我科进行治疗。我们进行了剖腹手术和活检检查。切除标本的免疫组织化学检查显示肿瘤细胞波形蛋白和β-连环蛋白呈阳性，诊断为硬纤维瘤。我们进行了小肠部分切除术和回盲部切除术。他术后恢复顺利，术后第12天出院。自手术以来的4个月随访中，他没有复发迹象。过去，手术是腹腔内硬纤维瘤的最佳治疗方法。但据报道，根据2019年NCCN指南中无症状和功能障碍的病例也可以进行观察等待。还需要进一步研究。
