内容紹介
Summary
A 40-year-old man with no previous history of abdominal surgery or noteworthy family history presented to our hospital because of a palpable abdominal mass. Abdominal CT revealed a 9 cm diameter mass in the mesocolon. The differential diagnosis included desmoid tumor, and right hemicolectomy with partial resection of the pancreas head and duodenum was performed. Pathologically, the tumor cells were negative for S-100, c-kit, CD34, and desmin but partially positive for α-SMA and slightly for β-catenin. From these findings, desmoid tumor of the mesocolon was diagnosed. Invasion of the pancreas was also found. Desmoid tumor is pathologically benign, but because of its malignant-like characteristics, such as direct invasion and local recurrence, it is treated as a malignant tumor. Desmoid tumors are associated with familial adenomatous polyposis coli and Gardner syndrome, or they arise in patients who have a history of laparotomy or antecedent trauma. In this paper, we report a rare case of resected sporadic desmoid tumor in the mesocolon with pancreatic invasion, together with a review of the literature.
要旨
症例は40歳,男性。既往歴,家族歴に特記事項なし。右上腹部腫瘤を自覚し,当院を受診した。腹部造影CT検査にて横行結腸間膜内に9.5×9.0 cmの内部不均一の分葉状腫瘤を認めた。また,膵頭部との境界が一部不明瞭であった。デスモイド腫瘍の術前診断で十二指腸,膵臓を一部合併切除する結腸右半切除術を施行した。病理組織学的所見はS-100,c-kit,CD34,desminはすべて陰性,α-SMAは部分的に陽性,β-cateninが弱陽性であり,腸間膜デスモイド腫瘍と診断した。また,病理組織学的に膵臓への直接浸潤も認めた。デスモイド腫瘍は家族性大腸腺腫症やGardner症候群,開腹手術,外傷の既往例に発生することが多いが,本症例のごとく上記を伴わない孤発例はまれであるため報告する。
目次
A 40-year-old man with no previous history of abdominal surgery or noteworthy family history presented to our hospital because of a palpable abdominal mass. Abdominal CT revealed a 9 cm diameter mass in the mesocolon. The differential diagnosis included desmoid tumor, and right hemicolectomy with partial resection of the pancreas head and duodenum was performed. Pathologically, the tumor cells were negative for S-100, c-kit, CD34, and desmin but partially positive for α-SMA and slightly for β-catenin. From these findings, desmoid tumor of the mesocolon was diagnosed. Invasion of the pancreas was also found. Desmoid tumor is pathologically benign, but because of its malignant-like characteristics, such as direct invasion and local recurrence, it is treated as a malignant tumor. Desmoid tumors are associated with familial adenomatous polyposis coli and Gardner syndrome, or they arise in patients who have a history of laparotomy or antecedent trauma. In this paper, we report a rare case of resected sporadic desmoid tumor in the mesocolon with pancreatic invasion, together with a review of the literature.
要旨
症例は40歳,男性。既往歴,家族歴に特記事項なし。右上腹部腫瘤を自覚し,当院を受診した。腹部造影CT検査にて横行結腸間膜内に9.5×9.0 cmの内部不均一の分葉状腫瘤を認めた。また,膵頭部との境界が一部不明瞭であった。デスモイド腫瘍の術前診断で十二指腸,膵臓を一部合併切除する結腸右半切除術を施行した。病理組織学的所見はS-100,c-kit,CD34,desminはすべて陰性,α-SMAは部分的に陽性,β-cateninが弱陽性であり,腸間膜デスモイド腫瘍と診断した。また,病理組織学的に膵臓への直接浸潤も認めた。デスモイド腫瘍は家族性大腸腺腫症やGardner症候群,開腹手術,外傷の既往例に発生することが多いが,本症例のごとく上記を伴わない孤発例はまれであるため報告する。