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[一例巨大腹腔内硬纤维瘤病例报告]

[A Case of Giant Intra-Abdominal Desmoid Tumor-A Case Report].

作者信息

Miyamoto Kotaro, Yamaguchi Daiki, Tada Takeshi, Nakayama Koichi, Urazumi Kojiro

机构信息

Dept. of Surgery, Jusendo General Hospital.

出版信息

Gan To Kagaku Ryoho. 2024 Oct;51(10):1059-1061.

Abstract

The patient was a 47-year-old woman. She had been aware of abdominal distension for several months and visited our hospital. Contrast CT revealed a 30 cm tumor with uneven contrast effect. MRI showed uniform low signal intensity on T1 weighted images and a mixture of low and high signal intensity on T2 weighted images. She was diagnosed with a giant ovarian tumor and underwent surgery at the gynecology department. Laparotomy revealed that the tumor originated in the small intestine mesentery rather than the ovary, and she was referred to our department during surgery. The tumor had involved the ileocolic artery and vein, and was removed by right hemicolectomy. The specimen was 32×32×27 cm and weighed approximately 8 kg. Histopathological examination showed proliferation of spindle cells. Immunohistochemistry showed negative staining for c-kit and positive staining for β-catenin. The tumor was diagnosed as an intra-abdominal desmoid tumor. Intra-abdominal desmoid is a rare disease, and diagnosis and surgical procedure are often difficult. We report a case of resection of a giant mesenteric desmoid tumor with a review of the literature.

摘要

患者为一名47岁女性。她数月来一直感到腹胀,遂前来我院就诊。增强CT显示一个30厘米的肿瘤,增强效果不均匀。MRI显示在T1加权图像上呈均匀低信号强度,在T2加权图像上呈低信号和高信号混合。她被诊断为巨大卵巢肿瘤,并在妇科接受了手术。剖腹探查显示肿瘤起源于小肠系膜而非卵巢,手术期间她被转诊至我科。肿瘤累及回结肠动静脉,通过右半结肠切除术将其切除。标本大小为32×32×27厘米,重约8千克。组织病理学检查显示梭形细胞增生。免疫组织化学显示c-kit染色阴性,β-连环蛋白染色阳性。该肿瘤被诊断为腹腔内硬纤维瘤。腹腔内硬纤维瘤是一种罕见疾病,诊断和手术操作通常都很困难。我们报告一例巨大肠系膜硬纤维瘤切除病例并复习相关文献。

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