Haueisen Figueiredo Zwetkoff Bruna, Maluf-Filho Fauze, Venco Filadélfio E, Blasbalg Roberto, Sobroza de Mello Evandro, de Almeida Barros Mauricio Fernando
Department of Endoscopy, Hospital Moriah, São Paulo, BRA.
Department of Gastroenterology, Cancer Institute, University of São Paulo, São Paulo, BRA.
Cureus. 2024 Nov 29;16(11):e74764. doi: 10.7759/cureus.74764. eCollection 2024 Nov.
This case report highlights the diagnostic challenges in distinguishing between metastatic peritoneal mesothelioma with duodenal involvement and synovial sarcoma of the duodenum, two rare and complex entities. A 59-year-old woman presented with nonspecific abdominal symptoms, and imaging revealed a heterogeneous lesion between the right hepatic lobe and duodenum. Endoscopic ultrasound-guided biopsy and subsequent histopathological analysis initially suggested synovial sarcoma, but further examination, including a FISH assay, confirmed the diagnosis of malignant peritoneal mesothelioma. This case underscores the importance of integrating detailed medical history, imaging, and advanced diagnostic techniques to achieve an accurate diagnosis in rare conditions. Early and precise identification of such diseases is crucial for appropriate therapeutic management and has significant implications for patient prognosis.
本病例报告强调了区分累及十二指肠的转移性腹膜间皮瘤和十二指肠滑膜肉瘤这两种罕见且复杂疾病时所面临的诊断挑战。一名59岁女性出现非特异性腹部症状，影像学检查显示右肝叶和十二指肠之间有一个不均匀的病变。内镜超声引导下活检及随后的组织病理学分析最初提示为滑膜肉瘤，但进一步检查，包括荧光原位杂交（FISH）检测，确诊为恶性腹膜间皮瘤。该病例强调了整合详细病史、影像学检查和先进诊断技术以在罕见疾病中实现准确诊断的重要性。早期准确识别此类疾病对于适当的治疗管理至关重要，对患者预后也有重大影响。
