Tumor fibroso solitario confinado en el mesenterio del intestino delgado (íleon)

Abstract

- 9 The aim of presenting this case was to provide current knowledge about SFT classi“cation and to report the 4th case of SFT in the small bowel mesentery. An 82-year-old man was brought to the emergency room of the Hospital Nacional Guillermo Almenara Irigoyen (HNGAI) by his relatives for medical attention due to 10 days of colicky abdominal pain that increased in intensity as the days went by; he also presented with nausea, vomiting, fever of 40 ◦ C, and sensory disorder. During a thorough anamnesis, the patient stated he had experienced similar symptoms 4 months earlier, associated with dyspepsia and involuntary weight loss of 3 kg at that time. Physical examination showed mild paleness, moderate pain upon palpation of the right hypochondrium, mesogastrium, and hypogastrium. In addition, a 15 x 15 cm painful mass was palpated in the hypogastrium, while the rest of the physical examination was unremarkable. A bowel transit time test indicated delayed transit, discreet dilation of the jejunoileal segments, and signs of ”occulation with no intramural images. A contrast-enhanced abdominal tomography scan revealed an expansive lesion with hypervascularity that was in contact with the distal ileum, associated with an alteration in the surrounding adipose tissues, and signs of hemoperitoneum predominating in the pelvic cavity recesses. The efferent venous drainage that was dependent on the mesenteric veins, whose diameters were enlarged, was striking, and the diagnostic imaging service recommended considering hemangioma, hemangiosarcoma, carcinoid tumor, hemangiopericytoma, and stromal tumor in the differential diagnoses. As a result of the discussion of the clinical cases of the coloproctology service of the HNGAI, an exploratory laparotomy + resection of the tumor of the distal ileum