Case Of Intra-abdominal Desmoid Tumor Research Articles

A case with mesenteric desmoid tumor after laparoscopic resection of stage I sigmoid colon cancer

BackgroundIntra-abdominal desmoid tumors are rare and generally occur in some patients with familial adenomatous polyposis or secondary to an external stimulus such as surgical trauma. We report herein a case of intra-abdominal desmoid tumor in the jejunal mesentery after laparoscopic colectomy for sigmoid colon cancer.Case presentationA 74-year-old woman underwent laparoscopic sigmoid colectomy for colon cancer with pathological stage I. Follow-up computed tomography (CT) 18 months after primary surgery showed a nodular and enhanced soft tissue density mass, 20 mm in size, in the mesentery at the left side of the abdomen. Serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels were within the normal range. Fluorodeoxyglucose positron emission tomography did not suggest cancer recurrence. Another CT scan, done 1 month later, revealed that the tumor had enlarged to 25 mm in size. Although the pathological diagnosis was not obtained, we suspected recurrence of the sigmoid colon cancer and applied chemotherapy using capecitabine, oxaliplatin, and bevacizumab. After 3 cycles of chemotherapy, however, the tumor had enlarged further. Therefore, the surgical resection of the tumor was performed to determine the diagnosis and to achieve possible curative resection of the tumor. The tumor existed in the mesentery of the jejunum, 100 cm from the ligament of Treitz, and showed invasive growth. We resected 40 cm of the jejunal segment together with the tumor. Microscopically, the tumor was composed of fibroblast, myofibroblast, and infiltrating the inflammatory cell and diagnosed as desmoid tumor by immunostaining (desmin+/−, β-catenin+, CD117−, vimentin+). At 33 months after the resection of the desmoid tumor, neither the sigmoid colon cancer nor desmoid tumor has had a recurrence.ConclusionsAfter surgery for gastrointestinal cancer, it is difficult to differentiate between intra-abdominal desmoid tumor and recurrence. The possibility of intra-abdominal desmoid should be considered along with tumor recurrence during postoperative surveillance after resection of gastrointestinal cancer, especially when the risk of recurrence is low.

A Case of Intra-Abdominal Desmoid Tumor with Peritonitis

A Case of Intra-Abdominal Desmoid Tumor with Peritonitis

開腹歴のない若年女性に発生した巨大腹腔内デスモイド腫瘍の１切除例

開腹歴のない若年女性に発生した巨大腹腔内デスモイド腫瘍の１切除例

腹腔鏡下に切除した腹腔内デスモイド腫瘍の１例

腹腔鏡下に切除した腹腔内デスモイド腫瘍の１例

Gardner's syndrome in a 40-year-old woman: successful treatment of locally aggressive desmoid tumors with cytotoxic chemotherapy

BackgroundDesmoid tumors that present as a part of Gardener's syndrome can present very difficult management problems.Case presetationWe report a case of intra-abdominal desmoid tumor causing distal small bowel obstruction that complicated the management of a more proximal enterocutaneous fistula from the jejunum. After failure of more conventional management options including imatinib, the patient's disease responded to doxorubicin and ifosfamide. The response resolved the bowel obstruction and allowed small intestinal resection to resolve the enterocutaneous fistula.ConclusionSystemic cytotoxic therapy with doxorubicin and ifosfamide can be useful for patients with complications from intra-abdominal desmoid tumor.