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乙状结肠侵袭性纤维瘤病:一例报告。

Aggressive fibromatosis of the sigmoid colon: A case report.

作者信息

Yu Pan-Pan, Liu Xin-Chun, Yin Lu, Yin Guang

机构信息

Department of Gastrointestinal and Anal Surgery, The Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University, Hangzhou 310006, Zhejiang Province, China.

Department of Gastric Surgery, Zhejiang Cancer Hospital, Hangzhou 310022, Zhejiang Province, China.

出版信息

World J Gastrointest Oncol. 2024 Aug 15;16(8):3716-3722. doi: 10.4251/wjgo.v16.i8.3716.

Abstract

BACKGROUND

Aggressive fibromatosis (AF), also known as desmoid tumor or desmoid-type fibromatosis, is a rare soft tissue neoplasm that can occur in almost any part of the body. Although it is a benign disease, AF is aggressive and infiltrative and has a high recurrence rate after surgery. Common sites for intra-abdominal AF are the small bowel mesentery, retroperitoneum, and pelvis. AF in the colon is extremely rare.

CASE SUMMARY

Here, we report the first case of sigmoid colon AF, which was accidentally discovered in a 27-year-old woman during laparoscopic myomectomy. Computed tomography confirmed a slightly enhanced mass in the sigmoid colon. Subsequent colonoscopy did not reveal a mass in the colonic lumen, but a suspected external compress was found in the sigmoid colon. Surgical disease involving a gastrointestinal stromal tumor was suspected. The patient underwent laparoscopic exploration, and sigmoidectomy with a negative margin was performed to excise the mass. Postoperative immunohistochemistry revealed that the mass was an AF. The patient recovered well and was recurrence-free at the 30-month follow-up without adjuvant therapy.

CONCLUSION

AF should be considered in the differential diagnosis of subepithelial colon masses. Radical resection alone can achieve good outcomes.

摘要

背景

侵袭性纤维瘤病(AF),也称为韧带样瘤或韧带样型纤维瘤病,是一种罕见的软组织肿瘤,几乎可发生于身体的任何部位。尽管它是一种良性疾病,但AF具有侵袭性和浸润性,术后复发率高。腹腔内AF的常见部位是小肠系膜、腹膜后和骨盆。结肠AF极为罕见。

病例摘要

在此,我们报告首例乙状结肠AF病例,该病例是在一名27岁女性行腹腔镜子宫肌瘤切除术时意外发现的。计算机断层扫描证实乙状结肠有一个轻度强化的肿块。随后的结肠镜检查未发现结肠腔内有肿块,但在乙状结肠发现疑似外部压迫。怀疑手术疾病为胃肠道间质瘤。患者接受了腹腔镜探查,并进行了切缘阴性的乙状结肠切除术以切除肿块。术后免疫组织化学显示肿块为AF。患者恢复良好,在30个月的随访中无复发,未接受辅助治疗。

结论

在鉴别诊断结肠上皮下肿块时应考虑AF。单纯根治性切除即可取得良好效果。

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