Kisu Eri, Hiraki Masatsugu, Okuyama Keiichiro, Maeda Sachiko, Takesue Shin, Kusaba Kana, Kai Keita, Manabe Tatsuya, Noshiro Hirokazu
Department of Surgery, Saga University Faculty of Medicine, 5-1-1 Nabeshima, Saga, 849-8501, Japan.
Department of Pathology, Saga University Faculty of Medicine, Saga, Japan.
Surg Case Rep. 2024 Jul 19;10(1):173. doi: 10.1186/s40792-024-01973-z.
Rosai-Dorfman disease (RDD) is an uncommon proliferative histiocytic disorder involving lymph nodes and various organs. Forty-three percent of RDD cases originate from extranodal sites; however, RDD rarely arises from the colon.
A 75-year-old man was admitted to our hospital because of intra-abdominal masses that were incidentally detected during surveillance by computed tomography (CT) after treatment for lung cancer. Enhanced CT showed two mass lesions located in the cecum to the appendix (diameter, 40 mm) and around the sigmoid colon (diameter, 24 mm). Positron emission tomography (PET)-CT revealed an apparent uptake of fluorodeoxyglucose. Intraluminal endoscopy did not reveal definite mucosal abnormalities. These findings suggest the presence of malignant neoplasms including gastrointestinal stromal tumors, lung cancer metastasis, and malignant lymphoma. Exploratory laparoscopy and/or tumor excision were planned to obtain a definitive diagnosis. Based on laparoscopic findings, ileocecal resection and sigmoidectomy were simultaneously performed to excise the tumors. Postoperative histopathological examination revealed multiple RDD originating from the mesocolon side of the cecum and the sigmoid colon. The patient did not receive any adjuvant therapy. No recurrence was observed one year after surgery.
RDD originating from the colon is extremely rare. Tumor extirpation or organ resection is sometimes required to obtain a definitive diagnosis of RDD, and minimally invasive surgery is helpful.
罗萨伊 - 多夫曼病(RDD)是一种罕见的增生性组织细胞疾病,可累及淋巴结和多个器官。43%的RDD病例起源于结外部位;然而,RDD极少起源于结肠。
一名75岁男性因肺癌治疗后接受计算机断层扫描(CT)监测时偶然发现腹腔肿块而入住我院。增强CT显示两个肿块病变,一个位于盲肠至阑尾处(直径40mm),另一个位于乙状结肠周围(直径24mm)。正电子发射断层扫描(PET)-CT显示氟脱氧葡萄糖有明显摄取。腔内内镜检查未发现明确的黏膜异常。这些发现提示存在包括胃肠道间质瘤、肺癌转移和恶性淋巴瘤在内的恶性肿瘤。计划进行 exploratory laparoscopy和/或肿瘤切除以明确诊断。根据腹腔镜检查结果,同时进行了回盲部切除术和乙状结肠切除术以切除肿瘤。术后组织病理学检查显示多个RDD起源于盲肠和乙状结肠的结肠系膜侧。患者未接受任何辅助治疗。术后一年未观察到复发。
起源于结肠的RDD极为罕见。有时需要进行肿瘤切除或器官切除以明确RDD诊断,微创手术是有帮助的。