A Case Of Sporadic Mesenteric Fibromatosis Mimicking Pancreatic Mass

Yıl 2015, Cilt: 40 Sayı: 1, 138 - 142, 09.09.2015

Halil Taşcı , Murat Çakır Hacı Esen

https://doi.org/10.17826/cutf.98718

Öz

The term abdominal fibromatosis refers to sporadic, pelvic, and mesenteric lesions and to all the fibromatosis lesions seen in Gardner’s syndrome. Sporadic fibromatosis, however, is very rarer and literature offers a limited number of cases. The 14-year-old female patient presented to our clinic with complaints of indefinite abdominal pain in the epigastric area for the last 2 months, dyspeptic problems, and vomiting after eating. Upon the patient’s gastroscopy revealed a mass lesion pressuring the stomach, endoscopic ultrasonography was performed. A hyperechoic mass lesion of 9x5 cm thought to have originated from the pancreatic tail was detected. The mass was surgically excised. Although mesenteric fibromatosis shows the characteristics of a benign tumor pathologically, it is extremely aggressive clinically and has a very high rate of recurrence. These patients should be treated like they have malign tumors and surgeons should perform surgical resection as wide as possible

Anahtar Kelimeler

Local recurrence, mesenteric fibromatosis, pancreas

Pankreatik Kitleyi Taklit Eden Sporadik Mezenterik Fibromatozis Olgusu

Öz

Abdominal fibromatozis sporadik, pelvik, mezenterik lezyonlar ile garder sendromunda görülen fibromatozis lezyonlarının hepsi için kullanılmaktadır. Sporadik fibromatozis ise çok daha nadirdir ve literatürde az sayıda vaka bildirilmiştir. 14 yaşında kadın hasta, 2 aydır olan epigastrik bölgede müphem karın ağrısı, dispeptik yakınmalar ve yemeklerden sonra olan kusma nedeni ile başvurdu. Yapılan gastroskopide mideye dıştan bası yapan kitle lezyonuna rastlanması üzerine endoskopik ultrasonografi yapıldı. Pankreas kuyruğundan kaynaklandığı düşünülen 9x5 cm ebadında hiperekoik kitle lezyonu görüldü.Cerrahi olarak kitle eksize edildi. Mezenterik fibromatozis patolojik olarak benign bir tümör özelliği göstermesine rağmen klinik olarak ileri derecede agresif ve nüks oranı oldukça yüksektir. Bu hastalara malign gibi davranıp mümkün olduğunca geniş cerrahi rezeksiyon uygulanmalıdır.

Anahtar Kelimeler

Lokal nüks, mezenterik fibromatozis, pankreas

Kaynakça

• Shields CJ, Winter DC, Kirwan WO, et al. Desmoid tumours. Eur J Surg Oncol. 2001;27:701-6. Ege Journal of Medicine. 2008;47:207-9.
• Al Jadaan SA, Al Rabeeah A. Mesenteric fibromatosis: case report and literature review. J Pediatr Surg. 1999;34:1130- 2.
• Weiss SW, Goldblum JR. Fibromatoses. In: Weiss SW, Goldblum JR, eds. Soft tissue tumors. 5th ed. China: Mosby Elsevier. 2008;247-9.
• Lahat G, Nachmany I, Itzkowitz E, Abu-Abeid S, Barazovsky E, Merimsky O, et al. Surgery for sporadic abdominal desmoid tumor: is low/no recurrence an achievable goal? Isr Med Assoc J. 2009;11:398-02.
• C.H.Yang, S. M. Sheen-Chen,C.C. Lu, S. F. Ko, andH. L. Eng, “Computed tomographic presentation ofmesenteric fibromatosis,” Digestive Diseases and Sciences. 2005;50:348–50.
• Yantiss RK, Spiro IJ, Compton CC, Rosenberg AE: Gastrointestinal stromal tumor versus intra-abdominal fibromatosis of the bowel wall. Am J Surg Pathol 2000;24:947-57.
• Burke AP, Sobin LH, Shekitka KM, Federspiel BH, Helwig EB: Intra-abdominal fibromatosis. A pathologic analysis of 130 tumors with comparison of clinical subgroups. Am J Surg Pathol. 1990;14:335- 41.
• Al-Salem AH, Al-Hayek R, Qureshi SS: Solitary intestinal fibromatosts: A rare cause of intestinal perforation in neonates. Pediatr Surg Int 1997;12:437-40.
• Numanoğlu A, Davies J, Millar AS: Congenital solitary intestinal fibromatosis. Eur J Pediatric Surg. 2002;12:337-40.
• Murayama T, Imoto S, Ito M, Matsushita K, Matozaki S, Nakagawa T, et al. Mesenteric fibromatosis presenting as fever of unknown origin. Am J Gastroenterol. 1992;87:1503-5.
• Kato Y, Tsuyuki A, Kikuchi K, Kurihara N, Fujishiro Y. Mesenteric fibromatosis succesfully resected with düodeno-jejunectomy and Neprectomy. Hepato- Gastroenterology. 2005;52:1730-3.
• Healy JC, Reznek RH, Clark SK, Phillips RK, Armstrong P. MR appearances of desmoid tumors in familial adenomatous polyposis. AJR Am J Roentgenol. 1997;169:465-72.
• J. A. Rodriguez, L. A. Guarda, and J. Rosai, “Mesenteric fibromatosis with involvement of the gastrointestinal tract. A GIST simulator: a study of 25 cases,”The American Journal of Clinical Pathology. 2004;121:93–8.
• Holubar S, Dwivedi AJ, O’Connor J. Giant Mesenteric Fibromatosis presenting as Small Bowel Obstruction. Am Surg. 2006;72:427-9.
• A. J. Smith, J. J. Lewis, N. B. Merchant, D. H. Y. Leung, J. M. Woodruff, and M. F. Brennan, “Surgical management of intraabdominal desmoid tumours,” The British Journal of Surgery. 2000;87:608–13.
• Paritosh C. Khanna, Chinar Lath, Swapna B. Gadewar, Dilpesh Agrawal. Inoperable aggressive mesenteric fibromatosis with ureteric fistula: Case report and literature review. European Journal of Radiology. 2006;5:117-21.
• Tauro LF, Sathyamoorthy PA, Hegde RB, Ravikrishnan HI, Singla MM. Giant desmoid tumor in the posterior abdominal wall/retroperitoneum. Indian J Surg. 2007;69:105-7.