1
|
Clarke-Brodber AL, Hartley CP, Ahmed F, Thangaiah JJ, Tiegs-Heiden C, Hagen CE. Desmoid fibromatosis involving the pancreas: A retrospective case series with clinical, cytopathologic and radiologic correlation. Ann Diagn Pathol 2022; 60:152015. [DOI: 10.1016/j.anndiagpath.2022.152015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 07/17/2022] [Indexed: 11/01/2022]
|
2
|
Park CG, Lee YN, Kim WY. Desmoid type fibromatosis of the distal pancreas: A case report. Ann Hepatobiliary Pancreat Surg 2021; 25:276-282. [PMID: 34053932 PMCID: PMC8180399 DOI: 10.14701/ahbps.2021.25.2.276] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 10/09/2020] [Indexed: 11/17/2022] Open
Abstract
A 23-year-old Korean female presented epigastric pain of two-months’ duration. She had a laparoscopic ovarian cyst excision 8 months previously. Clinical examination was normal. An abdominal computed tomogram (CT) demonstrated a 10-cm solid mass in the distal pancreas, with signs of splenic artery and vein occlusion, gastric and transverse colon invasion. Operative findings showed a mass involving distal pancreas, invasive to the posterior wall of the antrum of the stomach and transverse colon and 4th portion of the duodenum without lymph node involvement. The surgery consisted of a distal pancreatectomy, splenectomy and combined partial resection of the stomach, transverse colon and 4th portion of the duodenum. The immunohistochemistry and histopathological features were consistent with a confirmed diagnosis of intra-abdominal desmoid type fibromatosis (DTF). The prognosis of pancreatic DTF is not known and she showed no recurrence or distant metastasis during a 3 year follow-up. Herein we report a rare case with an isolated, sporadic, and non-trauma-related DTF, located at the pancreatic body and tail.
Collapse
Affiliation(s)
- Chan Gyun Park
- Department of Surgery, Presbyterian Medical Center, Jeonju, Korea
| | - Yu Ni Lee
- Department of Surgery, Presbyterian Medical Center, Jeonju, Korea
| | - Woo Young Kim
- Department of Surgery, Presbyterian Medical Center, Jeonju, Korea
| |
Collapse
|
3
|
Wang YC, Wong JU. Complete remission of pancreatic head desmoid tumor treated by COX-2 inhibitor-a case report. World J Surg Oncol 2016; 14:190. [PMID: 27450394 PMCID: PMC4957301 DOI: 10.1186/s12957-016-0944-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 07/09/2016] [Indexed: 11/10/2022] Open
Abstract
Background Desmoid tumors (DTs) are non-metastatic, locally aggressive neoplasms with high postoperative recurrence rates. The pancreas is an extremely rare location for DTs. The local control of DTs is challenging. Surgery and radiotherapy are currently the principal treatment modalities for DTs; however, some resections might not be radical, and radiotherapy has several drawbacks. Therefore, many studies have been focusing on the molecular pathways involved in DTs in order to develop molecular-targeted therapies or chemotherapy. Cyclooxygenase-2 (COX-2) has been demonstrated to play a role in the growth of DTs, and the pharmacologic blockade of COX resulted in decreased cell proliferation in desmoid cell cultures in vitro. Case presentation Herein, we report a 57-year-old woman who presented with recurrent epigastric pain and weight loss. An abdominal computed tomography scan showed an approximately 10-cm mass over the pancreatic head region and dilatation of the pancreatic duct. Tumor biopsy and bypass surgery were performed. A DT was confirmed on pathologic analysis. After resection, we prescribed treatment with the COX-2 inhibitor celecoxib. The patient showed complete remission and there was no local recurrence or distant metastasis within the 24-month follow-up period. Conclusions The outcome of this case study is encouraging, and long-term follow-up studies are required to establish the effect of treatment with celecoxib on the prognosis of DTs.
Collapse
Affiliation(s)
- Yu-Chieh Wang
- Division of General Surgery, Department of Surgery, Cathay General Hospital, Taipei, Taiwan
| | - Jia-Uei Wong
- Division of General Surgery, Department of Surgery, Cathay General Hospital, Taipei, Taiwan.
| |
Collapse
|
4
|
Pancreatic desmoid-type fibromatosis with beta-catenin gene mutation-Report of a case and review of the literature. Pathol Res Pract 2016; 212:484-9. [PMID: 26907785 DOI: 10.1016/j.prp.2016.02.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 12/28/2015] [Accepted: 02/07/2016] [Indexed: 11/21/2022]
Abstract
We experienced a rare case of pancreatic desmoid-type fibromatosis (DTF) in a 75-year-old Japanese woman. She was asymptomatic but routine examination including ultrasonography revealed a mass in the abdomen. For precise examination, she was referred to the regional hospital. Computed tomography showed that the mass was protruding anteriorly from the left-sided pancreas. Because of the enlargement of the mass lesion, distal pancreatectomy with splenectomy was performed after about 3 months. Macroscopically, the mass was encapsulated and approximately 8cm in diameter. Histological examination revealed that spindle or blunt stellate cells were proliferating in parallel or storiform fashion with myxoid and fibrous background. The tumor cells did not show prominent atypia and mitoses were rarely seen, suggesting that the tumor was low grade or borderline. Immunohistochemistry showed obvious nuclear staining of beta-catenin. Furthermore, analysis of beta-catenin gene revealed that the tumor had a typical missense mutation of threonine to alanine at colon 41 (T41A) in exon 3. These findings confirmed the pathological diagnosis of DTF of the pancreas. To the best of our knowledge, 18 cases of pancreatic DTF have been reported in the English literature and beta-catenin gene mutation had been examined in only one case among them. Thus, our case is the 19th pancreatic DTF and the second case with confirmed beta-catenin gene mutation.
Collapse
|
5
|
Muccino E, Gentile G, Mantero S, Marchesi M, Rancati A, Zoja R. The medico-legal observation of an aggressive urogenital fibromatosis with isolated development not related to any traumatic event. Forensic Sci Int 2016; 260:e1-e6. [PMID: 26786144 DOI: 10.1016/j.forsciint.2016.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 09/26/2015] [Accepted: 01/02/2016] [Indexed: 11/29/2022]
Abstract
Desmoid tumor is a fibroproliferative neoplasm with an intermediate malignancy and it can be localized in every bodily district: some locations are considered exceptional, like the urogenital localization. The Author point out a rare case of giant idiopathic scrotal fibromatosis that was found during an autopsy. A widower, that lived alone in poor hygienic conditions, was found dead in his house. The Judicial Authority ordered the autopsy, that was performed two days later at the Medico-Legal Section of Milan University. External examinations revealed only the considerable dimension of the scrotum (cm 24 × 41). The cause of death was fixed in a cardiac tamponade due to a natural heart laceration localized in correspondence of a transmural infarction. The toxicological exam resulted negative, while the histopathological and immunohistochemical analysis qualify the scrotal mass as a desmoids tumor. Due to the absence of predisposing conditions and of fibroproliferative infiltration in bladder and retroperitoneal space, the neoplasm was configured as an idiopathic desmoid tumor. The presented case gives the reason for the discussion concerning medico-legal aspects that are typical of rare neoplasms.
Collapse
Affiliation(s)
- Enrico Muccino
- Sezione di Medicina Legale e delle Assicurazioni-Dipartimento di Scienze Biomediche per la Salute- Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133 Milano MI, Italy
| | - Guendalina Gentile
- Sezione di Medicina Legale e delle Assicurazioni-Dipartimento di Scienze Biomediche per la Salute- Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133 Milano MI, Italy
| | - Stefano Mantero
- Centro Nazionale delle Ricerche-Istituto di Ricerca Genetica e Biomedica (IRGB)- Istituto Clinico Humanitas, Via Manzoni 113, 20089 Rozzano MI, Italy
| | - Matteo Marchesi
- Azienda Ospedaliera Papa Giovanni XXIII-Piazza OMS 1, 24127 Bergamo
| | - Alessandra Rancati
- Sezione di Medicina Legale e delle Assicurazioni-Dipartimento di Scienze Biomediche per la Salute- Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133 Milano MI, Italy
| | - Riccardo Zoja
- Sezione di Medicina Legale e delle Assicurazioni-Dipartimento di Scienze Biomediche per la Salute- Università degli Studi di Milano, Via Luigi Mangiagalli 37, 20133 Milano MI, Italy.
| |
Collapse
|
6
|
Abstract
Desmoid tumors, also known as desmoid-type fibromatoses or aggressive fibromatoses, are clonal fibroblastic proliferations that arise in the deep soft tissues. They are characterized by infiltrative growth, a tendency toward local recurrence and the inability to metastasize. We present a case of a 63-year-old woman who complained of abdominal pain, and a contrast-enhanced computed tomography scan revealed a well-circumscribed tumor in the pancreatic tail, measuring 5.1 cm. A left-sided, spleen-preserving pancreatic resection was performed, and pathological analysis showed a mesenchymal tumor. The diagnosis of a pancreatic desmoid tumor was made based on the characteristic morphology and the immune phenotype of the tumor. The English-language literature on pancreatic desmoid tumors was reviewed. In total, 16 previous cases were identified.
Collapse
Affiliation(s)
- Roxana Gerleman
- Department of Pathology, Odense University Hospital, Odense, Denmark
| | | | - Sönke Detlefsen
- Department of Pathology, Odense University Hospital, Odense, Denmark
| |
Collapse
|
7
|
Kallam AR, Ramakrishna BV, Roy GK, Karthik KRV. Desmoid tumours: our experience of six cases and review of literature. J Clin Diagn Res 2014; 8:NE01-4. [PMID: 25478405 DOI: 10.7860/jcdr/2014/9610.5032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2014] [Accepted: 09/11/2014] [Indexed: 11/24/2022]
Abstract
Desmoid tumours represent aggressive fibroblastic proliferation of the musculoaponeurotic structures commonly from the anterior abdominal wall. These tumours infiltrate locally, recur frequently but do not metastasize. Antecedent trauma, pregnancy and estrogens play a role in the etiopathogenesis of these tumours. In familial adenomatous polyposis (FAP) genetic history associated with chromosomal abnormality and familial incidence as in Gardner's syndrome is reported and most of these tumours are intraperitoneal either in the mesentery or pelvis and may be multiple and they carry poor prognosis. Surgery is the most preferred treatment and requires wide excision with 1 cm margin followed by reconstruction of the defect in the anterior abdominal wall either with local musculoaponeurotic layers or with synthetic mesh. In intra-abdominal cases associated with FAP in addition to surgery, hormonal treatment, chemotherapy and Radiotherapy are also advised depending upon the particular condition but usually prognosis is not encouraging. In this article we present our personal experience in the successful treatment of six cases of sporadic desmoids, five in females of child bearing age, and all in the anterior abdominal wall and one extra abdominal in a child aged 13 y in the gluteal region (Case 6). It is very interesting and unique to see two desmoid tumours developing in the same patient (Case2)one in each of the Rectus abdominal muscles (Right & Left).
Collapse
Affiliation(s)
- Anji Reddy Kallam
- Director & Plastic Surgeon, Alluri Sitarama Raju Institute of Medical Sciences , Eluru, AP, India
| | - B V Ramakrishna
- HOD, Department of Pathology, Alluri Sitarama Raju Institute of Medical Sciences , Eluru, AP, India
| | - G Kishore Roy
- HOD, Department of Orthopedics, Alluri Sitarama Raju Institute of Medical Sciences , Eluru, AP, India
| | - K R V Karthik
- Resident, Department of Orthopedics, Alluri Sitarama Raju Institute of Medical Sciences , Eluru, AP, India
| |
Collapse
|
8
|
Jia C, Tian B, Dai C, Wang X, Bu X, Xu F. Idiopathic desmoid-type fibromatosis of the pancreatic head: case report and literature review. World J Surg Oncol 2014; 12:103. [PMID: 24755337 PMCID: PMC4032157 DOI: 10.1186/1477-7819-12-103] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2013] [Accepted: 04/07/2014] [Indexed: 12/17/2022] Open
Abstract
Desmoid-type fibromatosis (DTF) is an uncommon nonmetastatic fibrous neoplasm. Sporadic intraperitoneal DTF is rarely described in current literature. We herein report a case of DTF of unknown cause involving the pancreatic head. A 41-year-old man presented with recurrent epigastric pain and weight loss. An abdominal computed tomography scan showed a well-delineated solid cystic mass inside the pancreatic head. Pylorus-preserving pancreaticoduodenectomy was performed due to the patient's debilitating symptoms and suspected malignancy. The pathological examination revealed massive fibroblastic proliferation arising from the musculoaponeurotic tissues, consistent with a diagnosis of DTF. Immunohistochemical phenotyping determined positive immunoreactivity to vimentin and β-catenin, but negative immunoreactivity to smooth muscle actin, CD117, CD34, or S-100, confirming the diagnosis of DTF. No local recurrence or distant metastasis was found during a 24-month follow-up. Radical resection is recommended as first-line treatment for pancreatic DTF. Long-term follow-up studies are required to establish the prognosis of pancreatic DTF.
Collapse
Affiliation(s)
- Changjun Jia
- Department of General Surgery, Shengjing Hospital, China Medical University, 36 Sanhao Street, Shenyang 110004, China
| | - Baoling Tian
- Department of Pathology, Shengjing Hospital, China Medical University, 36 Sanhao Street, Shenyang 110004, China
| | - Chaoliu Dai
- Department of General Surgery, Shengjing Hospital, China Medical University, 36 Sanhao Street, Shenyang 110004, China
| | - Xinlu Wang
- Department of Ultrasound Medicine, Shengjing Hospital, China Medical University, 36 Sanhao Street, Shenyang 110004, China
| | - Xianmin Bu
- Department of General Surgery, Shengjing Hospital, China Medical University, 36 Sanhao Street, Shenyang 110004, China
| | - Feng Xu
- Department of General Surgery, Shengjing Hospital, China Medical University, 36 Sanhao Street, Shenyang 110004, China
| |
Collapse
|
9
|
Sporadic intra-abdominal desmoid: a rare presentation as a hepatic mass. Case Rep Pathol 2012; 2012:245671. [PMID: 23091764 PMCID: PMC3471414 DOI: 10.1155/2012/245671] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Accepted: 09/05/2012] [Indexed: 12/27/2022] Open
Abstract
We report an unusual presentation of a sporadic intra-abdominal desmoid tumour, possibly arising from the diaphragm, masquerading as a hepatic mass in a young female without any history of surgery or trauma. Histopathology ruled out a hepatic origin of the tumour as was inferred from pre- and intraoperative evaluation. Immunohistochemistry showed positivity of lesional fibroblastic cells for β-catenin and negativity for CD34, CD117, EMA, SMA, desmin, vimentin, cytokeratin, and ALK1 thereby confirming the diagnosis of a desmoid tumour. There exist only a few reports in the literature on desmoids related to the diaphragm, but only one on a diaphragmatic desmoid that is possibly primary.
Collapse
|
10
|
|
11
|
Elguezabal Rodriguez A, Gené Hijós M, Caro Tarragó A, Martínez González S. [Intra-abdominal desmoid tumor mimicking a pancreatic tumor in a patient with familial colonic polyposis]. GASTROENTEROLOGIA Y HEPATOLOGIA 2011; 34:406-10. [PMID: 21571398 DOI: 10.1016/j.gastrohep.2011.03.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2010] [Revised: 02/25/2011] [Accepted: 03/01/2011] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Fibromatosis consists of a benign fibroblastic proliferation with local infiltrative growth. Two types are recognized: a superficial and a deep form, also known as desmoid tumor. The latter may occur sporadically or in association with familial adenomatous polyposis and Gardner's syndrome. Pancreatic presentation is exceptional and only eight cases have been described in the literature. CASE REPORT We report the case of a 29-year-old woman with a history of familial colonic polyposis and two pancreatic lesions. In the surgical specimen, two poorly defined pancreatic lesions were observed with infiltration of neighboring organs. Histologically, the lesions corresponded to mesenchymal proliferation with a fusocellular pattern without cytological atypica, which were diagnosed as desmoid tumors. DISCUSSION The etiology of fibromatosis is unknown. In patients with familial colonic polyposis, the most common localization of desmoid tumor is intra-abdominal. Pancreatic presentation is unusual, requiring differential diagnosis with other pancreatic neoplasms.
Collapse
|
12
|
Caliskan C, Korkut MA. Mesenteric fibromatosis of the ileocolic area: a case report. Indian J Surg 2011; 73:149-51. [PMID: 22468067 PMCID: PMC3077151 DOI: 10.1007/s12262-010-0202-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2009] [Accepted: 03/03/2009] [Indexed: 10/18/2022] Open
Abstract
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.
Collapse
|
13
|
Sporadic, nontrauma-related, desmoid tumor of the pancreas: a rare disease-case report and literature review. Case Rep Med 2010; 2010:272760. [PMID: 20300597 PMCID: PMC2838224 DOI: 10.1155/2010/272760] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2009] [Revised: 01/31/2010] [Accepted: 02/10/2010] [Indexed: 12/22/2022] Open
Abstract
Desmoid tumors (DTs) are neoplasms of fibroblastic origin characterized by lack of a capsule. They are nonmetastatic and locally aggressive. Intraabdominal DTs are often observed in familial adenomatous polyposis and Gardner syndrome or subsequent to localized traumatic injury. Sporadic forms are defined as nontrauma- or nongenetic-related DTs. Isolated, sporadic pancreatic DTs have been considered anecdotal, with only 9 cases described in the literature. We report the case of a 68-year-old man with a case of sporadic cystic DT localized to the pancreatic tail. The tumor was discovered incidentally during computerized tomography performed for an unrelated condition. The patient was asymptomatic; however, biopsy was performed on the clinical suspicion of cystic cancer of the pancreas. Pathology analysis showed fibroblastic proliferation, and the diagnosis of DT was confirmed by immunohistochemical staining for beta-catenin. The patient underwent resection with no further treatment and remain disease-free 60 months after surgery.
Collapse
|
14
|
Unusual presentation of desmoid tumor in the small intestine: a case report. Med Oncol 2010; 28:159-62. [PMID: 20107932 DOI: 10.1007/s12032-010-9429-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2009] [Accepted: 01/11/2010] [Indexed: 12/20/2022]
Abstract
Desmoid tumor originating from the small intestine is extremely rare. We report a 50-year-old man who presented with the sudden onset of severe abdominal pain. Computerized tomography (CT) demonstrated a huge homogeneous tumor in the lower abdomen that appeared to be in continuity with the distal ileum. The mass adherent to the ileum was resected and proved to be a desmoid tumor. The patient has remained recurrence free on follow-up.
Collapse
|
15
|
Rampone B, Pedrazzani C, Marrelli D, Pinto E, Roviello F. Updates on abdominal desmoid tumors. World J Gastroenterol 2008. [PMID: 18023087 DOI: 10.3748/wjg.13.5985] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Desmoid tumor is a monoclonal, fibroblastic proliferation arising in musculoaponeurotic structures. This connective tissue hyperplasia infiltrates locally, recurs frequently after resection but does not metastasize. Abdominal desmoid occurs sporadically, in association with some familial syndromes and often represents a clinical dilemma for surgeons. The enigmatic biology and anatomical location of abdominal desmoids make treatment recommendations difficult. This distinct pathological entity is reviewed with a specific focus on aetiology and management.
Collapse
Affiliation(s)
- Bernardino Rampone
- Department of General Surgery and Surgical Oncology, Unit of Surgical Oncology, University of Siena, Policlinico Le Scotte, viale Bracci, 1, 53100, Siena, Italy.
| | | | | | | | | |
Collapse
|
16
|
Rampone B, Pedrazzani C, Marrelli D, Pinto E, Roviello F. Updates on abdominal desmoid tumors. World J Gastroenterol 2008; 13:5985-8. [PMID: 18023087 PMCID: PMC4250878 DOI: 10.3748/wjg.v13.45.5985] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Desmoid tumor is a monoclonal, fibroblastic proliferation arising in musculoaponeurotic structures. This connective tissue hyperplasia infiltrates locally, recurs frequently after resection but does not metastasize. Abdominal desmoid occurs sporadically, in association with some familial syndromes and often represents a clinical dilemma for surgeons. The enigmatic biology and anatomical location of abdominal desmoids make treatment recommendations difficult. This distinct pathological entity is reviewed with a specific focus on aetiology and management.
Collapse
Affiliation(s)
- Bernardino Rampone
- Department of General Surgery and Surgical Oncology, Unit of Surgical Oncology, University of Siena, Policlinico Le Scotte, viale Bracci, 1, 53100, Siena, Italy.
| | | | | | | | | |
Collapse
|
17
|
Weiss ES, Burkart AL, Yeo CJ. Fibromatosis of the remnant pancreas after pylorus-preserving pancreaticoduodenectomy. J Gastrointest Surg 2006; 10:679-88. [PMID: 16773761 DOI: 10.1016/j.gassur.2005.09.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Intra-abdominal fibromatosis or desmoid tumors are rare forms of connective tissue cellular dysplasia characterized by proliferation of fibroblasts and abundant collagen. Most often these tumors associated with familial adenomatous polyposis or Gardner's syndrome. Those tumors not associated with polyposis are termed sporadic desmoids and tend to be locally aggressive in nature. Sporadic intra-abdominal desmoids involving the pancreas are quite rare, as only six previously reported cases exist. In this report we present a seventh case of a sporadic intraabdominal desmoid involving the pancreas. The patient, a 63-year-old white man, developed the desmoid tumor following a pylorus-preserving pancreaticoduodenectomy for an insulinoma. The patient was managed via further pancreatectomy, consisting of a distal pancreatectomy with en bloc splenectomy, sparing a 6-cm portion of pancreatic neck and proximal body. Finally, we present a complete review of the six previous cases of sporadic pancreatic fibromatosis.
Collapse
Affiliation(s)
- Eric S Weiss
- Department of Surgery, The Sol Goldman Pancreas Cancer Research Center, The Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | | | | |
Collapse
|