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1例以肠套叠为表现的升结肠血管周上皮样细胞瘤：病例报告

A Case of Ascending Colon Perivascular Epithelioid Cell Tumor Presenting with Intestinal Intussusception: Case Report.

作者信息

Yokota Mitsuki, Takahashi Hidekazu, Tsuji Hiromi, Iwami Yuka, Watsapol Juavi Jitjan, Takaichi Shohei, Paku Masakatsu, Iwamoto Kazuya, Ohashi Tomofumi, Nakahara Yujiro, Asaoka Tadafumi, Matsuda Chu, Nishikawa Kazuhiro, Takemasa Ichiro, Omori Takeshi

机构信息

Department of Gastroenterology, Osaka Police Hospital, Osaka, Osaka, Japan.

Department of Pathology, Osaka General Medical Center, Osaka, Osaka, Japan.

出版信息

Surg Case Rep. 2025;11(1). doi: 10.70352/scrj.cr.24-0090. Epub 2025 Jun 17.

DOI:10.70352/scrj.cr.24-0090
PMID:40538427
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12177569/
Abstract

INTRODUCTION

Perivascular epithelioid cell tumors (PEComas) arising from the colon are uncommon. This case report describes a 40-year-old woman who presented with lower abdominal pain and was subsequently diagnosed with a colonic PEComa causing intestinal intussusception.

CASE PRESENTATION

The patient initially presented with lower right abdominal pain. Computed tomography revealed an intestinal mass in the ileocecal region, prompting surgical intervention. Due to the nature of the mass, endoscopic repair was not feasible, and she underwent an emergency laparoscopic ileocecal resection. A significant mass was identified in the ascending colon, comprising proliferating spindle-shaped cells within the colonic wall. Immunohistological analysis revealed positive staining for smooth muscle actin (+), HMB-45 (+), and MelanA (±), confirming the diagnosis of PEComa. The patient recovered uneventfully and was discharged on postoperative day 7.

CONCLUSIONS

Colonic PEComa is a rare malignancy. This case adds to the existing knowledge regarding intestinal intussusception caused by colonic PEComa.

摘要

引言

起源于结肠的血管周上皮样细胞瘤（PEComas）并不常见。本病例报告描述了一名40岁女性，她因下腹部疼痛就诊，随后被诊断为导致肠套叠的结肠PEComa。

病例介绍

患者最初表现为右下腹部疼痛。计算机断层扫描显示回盲部有一个肠肿块，促使进行手术干预。由于肿块的性质，内镜修复不可行，她接受了急诊腹腔镜回盲部切除术。在升结肠发现一个较大的肿块，由结肠壁内增生的梭形细胞组成。免疫组织学分析显示平滑肌肌动蛋白（+）、HMB-45（+）和MelanA（±）呈阳性染色，证实为PEComa。患者恢复顺利，术后第7天出院。

结论

结肠PEComa是一种罕见的恶性肿瘤。本病例增加了关于结肠PEComa引起肠套叠的现有知识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d81d/12177569/8fb8bffcb488/scr-11-01-24-0090-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d81d/12177569/d771eee3ce60/scr-11-01-24-0090-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d81d/12177569/4d3acbe7401a/scr-11-01-24-0090-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d81d/12177569/668424437c05/scr-11-01-24-0090-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d81d/12177569/8fb8bffcb488/scr-11-01-24-0090-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d81d/12177569/d771eee3ce60/scr-11-01-24-0090-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d81d/12177569/4d3acbe7401a/scr-11-01-24-0090-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d81d/12177569/668424437c05/scr-11-01-24-0090-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d81d/12177569/8fb8bffcb488/scr-11-01-24-0090-g004.jpg

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本文引用的文献

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Case Report: Perivascular epithelioid tumors of the gastrointestinal tract.病例报告：胃肠道血管周上皮样肿瘤
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Pediatric case of colonic perivascular epithelioid cell tumor complicated with intussusception and anal incarceration: A case report.
小儿结肠血管周上皮样细胞瘤合并肠套叠及肛门嵌顿1例：病例报告
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Perivascular epithelioid cell tumour (PEComa): an unusual cause of painful defaecation.血管周上皮样细胞瘤（PEComa）：引起排便疼痛的不常见病因。
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A case of caecal "PECOMA": An uncommon entity.一例盲肠“PECOMA”：一种罕见的疾病。
Int J Surg Case Rep. 2022 Jan;90:106689. doi: 10.1016/j.ijscr.2021.106689. Epub 2021 Dec 21.
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A Curious Case of Colonic Perivascular Epithelioid Cell Tumor: A Unique Diagnosis With Variable Presentations.一例罕见的结肠血管周上皮样细胞瘤：具有多种表现形式的独特诊断
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