Harada N, Shimada Y, Imamura M, Yamabe H, Furuyama H, Fujisawa I
1st. Department of Surgery, Kyoto University.
Nihon Geka Hokan. 1994 Jul 1;63(4):155-60.
A patient, a 63 year-old-man, was admitted suffering from discomfort in the left abdominal area; this proved to be a case of leiomyosarcoma of the mesentery. An upper gastrointestinal series revealed stenosis in the 3rd portion of the duodenum, and shift of the entire intestine to the right side. Computed tomography showed a giant mass lesion with a central necrosis. Selective arterial angiography showed a heterogeneous tumor stain with several feeders and drainage veins. A partial resection of the intestine around the Treitz's ligament and left hemicolectomy was required due to the tumor's invasion of the intestinal wall and transverse colon. The operation was successfully performed supported by the angiographic findings. The resected tumor was 23 cm in diameter, 2330 g in weight, and was filled with blood. The histological diagnosis was leiomyosarcoma of the mesentery. The patient has been doing well during the 6 months postoperative period.
一名63岁男性患者因左腹部不适入院;经诊断为肠系膜平滑肌肉瘤。上消化道造影显示十二指肠第三段狭窄,整个肠道向右移位。计算机断层扫描显示有一个巨大的肿块病变,中央坏死。选择性动脉血管造影显示肿瘤染色不均匀,有几条供血动脉和引流静脉。由于肿瘤侵犯肠壁和横结肠,需要对Treitz韧带周围的肠段进行部分切除并进行左半结肠切除术。在血管造影结果的支持下,手术顺利完成。切除的肿瘤直径23厘米,重2330克,充满血液。组织学诊断为肠系膜平滑肌肉瘤。术后6个月患者情况良好。