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1.
Takeshi Fujita Kinji Kamiya Yoshiaki Takahashi Shinichiro Miyazaki Ichirota Iino Hirotoshi Kikuchi Yoshihiro Hiramatsu Manabu Ohta Satoshi Baba Hiroyuki Konno 《World journal of gastrointestinal surgery》2013,5(3):62-67
We report a rare case of paraganglioma that developed in the mesentery of terminal ileum. A 78-year-old woman complained of right-sided abdominal pain. Abdominal computed tomography revealed a solid heterogeneously enhanced mass in the right lower abdomen. The tumor was laparoscopically excised. The mesenteric tumor was well circumscribed, ovoid, and encapsulated and measured 3 cm × 1.5 cm × 1.5 cm. Histological examination showed a cellular neoplasm comprised of nests and groups of tumor cells separated by fibrovascular connective tissue, giving a characteristic nested Zellballen pattern. Immunohistochemically, the tumor cells were positive for chromogranin, synaptophysin, CD56, and vimentin and negative for cytokeratins, SMA, CD34, CD117/c-kit and S100. On the basis of histologic and immunohistochemical features, a diagnosis of mesenteric paraganglioma was made. The operative and postoperative courses were unremarkable, and the patient was discharged on postoperative day 7. She was doing well 1 year after the surgery with no signs of recurrence. Extra-adrenal paragangliomas most commonly develop adjacent to the aorta, particularly the area corresponding to the organ of Zuckerkandl. Mesenteric paraganglioma, as in our case, is extremely rare; only 11 cases have been reported in the literature. We herein discuss the clinical findings of these cases. 相似文献
2.
Yasuhiro Fujino Yutaka Nagata Kazunori Ogino Hajime Watahiki Hiroshi Ogawa Yoichi Saitoh 《Surgery today》1998,28(2):209-212
(Received for publication on Apr. 30, 1996; accepted on Mar. 4, 1997) 相似文献
3.
S. Miliaras S. Trygonis A. Papandoniou S. Kalamaras C. Trygonis D. Kiskinis 《Acta chirurgica Belgica》2013,113(6):714-716
Mesenteric cysts are rare benign, lesions that are discovered accidentally or during the management of one of their complications (torsion, rupture, haemorrhage, obstruction of nearby organs). We present the case of a 56-year old female patient, with a mesenteric cyst of the descending colon, discovered accidentally during a routine gynaecological examination. Preoperative evaluation included U/S scan, IVP, CT scan and MRI scan. She underwent exploratory laparotomy and the cyst was enucleated intact. Postoperative period was uneventful and pathological examination showed a benign mesenteric lymphangioma. The patient is free of symptoms on 1-year follow-up. We also review the literature. 相似文献
4.
Agnes Witkiewicz Avi Galler Charles J. Yeo Samuel D. Gross 《Journal of gastrointestinal surgery》2007,11(10):1351-1354
Gangliocytic paraganglioma is a rare tumor, which occurs nearly exclusively in the second portion of the duodenum. Generally,
this tumor has a benign clinical course, although rarely, it may recur or metastasize to regional lymph nodes. Only one case
with distant metastasis has been reported. We present a case of duodenal gangliocytic paraganglioma treated first by local
resection followed by pylorus-preserving pancreaticoduodenectomy. Examination of the first specimen revealed focal nuclear
pleomorphism and mitotic activity, in addition to the presence of three characteristic histologic components: epithelioid,
ganglion, and spindle cell. In the subsequent pancreaticoduodenectomy specimen, there was no residual tumor identified in
the periampullary area, but metastatic gangliocytic paraganglioma was present in two of seven lymph nodes. This case report
confirms the malignant potential of this tumor. We review the published literature on gangliocytic paragangliomas pursuing
a malignant course. We conclude that surgical therapy of these neoplasms should not be limited to local resection, as disease
recurrence, lymph node involvement, and rarely distant metastasis may occur. 相似文献
5.
目的:探讨原发性腹膜后副神经节瘤的临床和病理特点、诊治方法及预后。方法:回顾性分析14例病理检查证实为腹膜后副神经节瘤患者的临床资料:男8例,女6例,年龄14~66岁。有高血压症状9例,其中尿香草扁桃酸(VMA)升高8例,尿儿茶酚胺升高9例。14例均接受手术治疗。术后随访13个月~5年。结果:术中见肿瘤位于肾门区4例,肾上极区5例,肾下极区2例,肾上腺前外上方3例。13例手术完全切除肿瘤,1例伴肝转移者行肿瘤大部切除及肝尾叶切除。病理检查诊断为良性肿瘤13例,恶性肿瘤1例。术后随访12例,9例术前高血压者有7例血压恢复正常;9例无瘤生存,1例复发,2例死亡。结论:手术完全切除肿瘤是腹膜后副神经节瘤最有效的治疗方法,充分的术前准备和围手术期处理是手术成功的关键。术后生存时间取决于肿瘤是否发生淋巴结或远处转移,复发病例可再次手术切除。 相似文献
6.
A 31-year-old man underwent a laparotomy for acute intestinal obstruction symptoms, which he had intermittently experienced for 14 years. The cause of the obstruction was due to a volvulus of the small bowel caused by a mesenteric lipoma. This is a rare finding, which is ideally diagnosed by computed tomography, with surgery the best and most highly recommended treatment. This particular presentation, to the best of our knowledge, has not yet been previously reported in the English language. 相似文献
7.
Mesenteric tumors are rare and consist of a heterogeneous group of lesions. Masses may arise from any of the mesenteric components: peritoneum, lymphatic tissue, fat, and connective tissue. Cellular proliferation can also arise from infectious or inflammatory processes. They can be classified as solid or cystic, benign or malignant. Mesenteric tumors are usually discovered incidentally or during investigation of non-specific symptoms. While clinical examination and imagery may suffice to make the diagnosis, histopathology is often required by either needle percutaneous or surgical biopsy, or immediate excision. Therapeutic management options vary widely depending on the nature of the lesion; they range from simple observation or medical therapy to surgery. Benign well-delineated mesenteric masses that are symptomatic can often be treated by simple enucleation. But invasive malignant tumors require a carcinologic resection; a careful preoperative evaluation to assess the relationship between the mass and adjacent vascular and digestive structures is essential since they may dictate the need for extensive sacrifice of bowel with resultant intestinal insufficiency due to short bowel syndrome. 相似文献
8.
A 77-year-old woman was admitted with intermittent abdominal dull pain. Hypochromic anemia, hypergammaglobulinemia, and elevated
C-reactive protein were found in this case. Ultrasonography, computed tomography, magnetic resonance imaging, and angiography
indicated either mesenteric leiomyoma or leiomyosarcoma, but no definitive preoperative diagnosis could be established. A
surgical resection of the tumor revealed a mesenteric Castleman's tumor with small daughter lymphoid tumors of plasma cell
type.
Received: May 24, 2001 / Accepted: January 8, 2002 相似文献
9.
Mesenteric venous thrombosis (MVT) is a catastrophic form of mesenteric vascular occlusion. In the absence of peritoneal signs,
anticoagulation therapy should be started immediately. For selected patients, thrombolysis through the superior mesenteric
artery (SMA), jugular vein, or portal vein via a transhepatic route might be successful; however, exploratory laparotomy is
mandatory when peritoneal signs develop. We report a case of acute MVT associated with protein C and S deficiency, treated
successfully by limited bowel resection and simultaneous thrombolytic infusion, given via an operatively placed mesenteric
vein catheter. 相似文献
10.
Fibromatosis is a kind of spindle cell tumor which is characterized by the remarkable proliferation and invasive growth of
fibrous tissue. It often arises from the abdominal wall or the extremities and rarely from the mesentery and abdominal organs.
The patient was 35 year old female whose major complaints were an abdominal mass and pain. She underwent a right hemicolectomy
after the tumor was confirmed by abdominal ultrasonography and computerized tomography. Hereby the pathophysiology, diagnosis
and the treatment of the disease is discussed. 相似文献
11.
Retractile mesenteritis is a rare idiopathic inflammatory process of the mesenteric adipose tissue. A 58-year-old woman who presented with acute abdominal pain and vomiting underwent laparotomy for a small bowel obstruction of unknown etiology. The laparotomy showed dilated small bowel loops and multiple tumor-like fibrous plaques in the mesentery. Histological examination revealed nonspecific chronic inflammatory processes of the mesentery. The computed tomography finding of increased density of the mesenteric fat, known as the fat-ring sign, in a patient with small bowel obstruction and no surgical history would suggest this rare diagnosis. 相似文献
12.
Prothrombin 20210 G/A Defect as a Cause of Mesenteric Venous Infarction: Report of a Case 总被引:1,自引:0,他引:1
A 50-year-old man with abdominal pain, nausea, and vomiting presented at our emergency department. Physical examination revealed
diffuse abdominal tenderness and absent bowel sounds. Computed tomography showed partial portal vein thrombosis extending
to the right portal vein and the superior mesenteric vein, perfusion defects in the liver, and nonopacified intestinal segment
after contrast injection. An emergency laparotomy was performed. The wall of the distal jejunum was edematous, congested,
and a 10-cm jejunal segment was necrotic. A partial intestinal resection and a primary anastomosis were performed. Screening
for thrombophilia revealed a heterozygote 20210 G/A mutation of the prothrombin gene. Anticoagulation was initiated. Computed
tomography 45 days after surgery showed a complete dissolution of the thrombi and cavernous transformation in the main portal
vein. His subsequent clinical course was uneventful. Mesenteric venous thrombosis which causes an intestinal infarction is
rare, and also difficult to diagnose. However, a prothrombin 20210 defect should be considered in the differential diagnosis
of patients with unexplained thrombosis. 相似文献
13.
目的归纳膀胱副神经节瘤的临床一般特征、诊断及治疗。方法收集兰州大学第二医院2013年3月—2020年8月所有膀胱肿瘤患者术后病理结果,对术后病理证实为副神经节瘤的7例患者的临床资料及随访结果进行回顾性分析。结果7例中术前明确诊断2例。7例均成功完成手术治疗。经尿道膀胱肿瘤电切术4例[2例术程平稳;2例术中出现血压剧烈波动,经过积极降压1例最终完成手术、另1例取活检后终止手术(院外积极酚苄明准备,3月后再次入院行腹腔镜下膀胱部分切除术)];1例行经尿道膀胱肿瘤激光剜除术,术程平稳;腹腔镜下膀胱部分切除3例(包括上述因术中血压无法有效控制中止手术者1例),平均手术时间130(30~180)min,平均术中出血30(20~50)mL。术后无相关并发症发生,术后住院3~5 d后恢复良好出院。1例发现肿瘤远处转移建议转外院继续治疗。7例均获随访,全身转移1例于外院治疗效果不佳,其余6例症状均有所改善,影像学检查未发现复发征象。远期结果仍有待进一步随访。结论膀胱副神经节瘤术前明确诊断困难,往往误诊为膀胱恶性肿瘤。手术为一线治疗方式,腹腔镜下膀胱部分切除术体现出微创优势,术后恢复快,部分选择性病例采用经尿道膀胱肿瘤电切术,同样可取得良好临床结果。 相似文献
14.
A 50-year-old man presented with a 24-h history of gradually worsening abdominal pain. Enhanced computed tomography showed
segmental dilation of the small intestine, wall thickening, and ascites, as well as thrombosis of the superior mesenteric
vein (SMV) and portal vein. Thus, an emergency laparotomy was performed, which revealed segmental intestinal infarction caused
by the thrombosis in the SMV and portal vein. We resected the necrosed intestine and performed anastomosis. The patient was
given intravenous heparin and nafamostat mesilate as anticoagulation therapy. The abdominal pain again recurred 4 days after
this operation, necessitating a second laparotomy. Segmental congestion of the intestine was found and another resection was
done, after which he recovered rapidly. Blood chemistry subsequently revealed an antithrombin III deficiency, which was confirmed
to be inherent, after screening his family. Thus, laboratory testing for these proteins may help define the cause of mesenteric
venous thrombosis. 相似文献
15.
Jasneet Singh Bhullar Paraskevi Orfanou 《JSLS, Journal of the Society of Laparoendoscopic Surgeons》2014,18(2):319-322
Introduction:
Mesenteric pseudocyst is a term used to describe an abdominal cystic mass with an unknown abdominal origin. They are rare intra-abdominal masses, with a reported incidence of approximately 1 per 100,000 to 250,000 hospital admissions. Most cysts are benign and they may present differently, such as a disappearing mass or a mass that changes locations, thus posing a diagnostic challenge to the clinician.Case Report:
We describe a case of a 29-year-old woman who presented with a 2-year history of feeling a large mass within her abdomen, which would then disappear for several days and would frequently change position and be felt in different quadrants of her abdomen. Computed tomography scan of the abdomen revealed a large cystic structure, and a computed tomography–guided biopsy was inconclusive. Diagnostic laparoscopic surgery revealed a firm mass arising from the jejunal mesentery; the patient underwent an en bloc resection. Histopathologic examination of the resected mass revealed a rare diagnosis of mesenteric pseudocyst. Mesenteric pseudocyst should be should be kept high on the list of differential diagnoses when a patient presents with a disappearing mass and/or an abdominal mass that changes location. 相似文献16.
Heidi Hornbeek N. Gopalakrishna Iyer Diane L. Carlson Hilda E. Stambuk Mabel Ryder Ian Ganly 《Skull base》2010,20(6):491-496
We report a case of functional vagal paraganglioma to illustrate the biochemical and radiological imaging tests important in diagnosis and to highlight the importance of a multidisciplinary team approach to manage the preoperative, perioperative, and postoperative effects of catecholamine secretion from these tumors. 相似文献
17.
Mesenteric inflammatory veno-occlusive disease (MIVOD) is a rare but increasingly recognized cause of intestinal ischemia.
It can be defined as phlebitis or venulitis affecting either the bowel or mesentery, without any evidence of coexisting arterial
inflammatory involvement or an obvious predisposing cause. We report the clinicopathological characteristics of five patients
who, after presenting with an acute abdomen, underwent exploratory laparotomy and resection of ischemic bowel. The distinctive
histopathological characteristics of MIVOD were identified in all five patients. We review the literature on this under-reported
condition. 相似文献
18.
Mesenteric leiomyosarcoma occurs most commonly in middle-aged individuals. Primary tumors of the mesentery are uncommon in pediatric and adolescent patients, and primary mesenteric leiomyosarcoma is particularly rare. Accurate preoperative diagnosis of mesenteric soft tumor is generally difficult. We describe a case of leiomyosarcoma arising from the ileal mesentery in a 13-year-old boy. The diagnosis was based on histopathologic evaluation using immunohistochemical staining and gene analysis. 相似文献
19.
Chylous Mesenteric Cyst : Case Report 总被引:1,自引:1,他引:0
Block FB 《Annals of surgery》1948,128(1):158-160
20.
IntroductionInflammatory pseudotumor (IP) is an uncommon benign neoplasm. It was first described in the lung but it has been recognized in several somatic and visceral locations. Mesenteric presentation is rare and its clinical presentation is variable but patients can be completely asymptomatic. Complete surgical resection is the only curable treatment. Rational follow-up protocols have not been established yet.Presentation of caseA 57 years-old man, with no relevant comorbidities and completely asymptomatic, apart from a lump on the right hypochondrium, was submitted to surgical resection of a large mesenteric mass. The preoperative Computed Tomography suggested gastrointestinal stromal tumor as the most probable diagnosis. Definitive histological examination of the completely resected surgical specimen confirmed the diagnosis of IP. The patient has been on follow-up for four years, without no evidence of recurrence.DiscussionThe preoperative diagnosis of IP may be difficult to establish mainly due to the lack of a typical clinical presentation. It is a rare entity, particularly in the adult population. These two aspects make it easier to neglect this entity in the differential diagnosis of an abdominal mass on asymptomatic adults. Although there are no formal guidelines on follow-up, close follow-up seems to be advisable in these patients as recurrence is frequent.ConclusionIP should be present as a possible differential diagnosis in an abdominal mass. Complete excision of the lesion can be curable but close follow-up seems to be required. 相似文献