Intra-abdominal small intestinal desmoid tumour mimicking GIST

2021 ◽  
Vol 14 (2) ◽  
pp. e237032
Author(s):  
Sai Krishna Eswaravaka ◽  
Swanit Hemant Deshpande ◽  
Roshan Chiranjeev ◽  
Jayashri Sanjay Pandya
Keyword(s):  
Smooth Muscle Actin ◽  
Abdominal Mass ◽  
Aggressive Fibromatosis ◽  
Mesenchymal Cell ◽  
Exploratory Laparotomy ◽  
Desmoid Tumour ◽  
Uneventful Recovery ◽  
Pathology Report ◽  
Beta Catenin ◽  
Desmoid Tumours

Desmoid tumours, also known as aggressive fibromatosis, are fibromuscular neoplasms that arise from mesenchymal cell lines. Desmoid tumours are usually benign and are locally aggressive tumours. We report a case of a 31-year-old man presenting with abdominal mass associated with dyspepsia and early satiety. CT scan demonstrated a large heterogeneous mass adherent to or arising from the jejunum. The patient underwent a successful elective exploratory laparotomy with resection of the tumour arising from the wall of the ileum with a 10 cm margin. The patient had an uneventful recovery and no recurrence at 6-month follow-up. Pathology report and immunohistochemistry analysis revealed the mass to be a primary desmoid tumour of the small bowel, as the tumour was negative for c-kit and Discovered on GIST 1 (DOG-1) and positive for beta-catenin and smooth muscle actin.

scholarly journals Aggressive fibromatosis of the right colon mimicking a gastrointestinal stromal tumour: a case report

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199492
Author(s):  
Milica Mitrovic Jovanovic ◽  
Aleksandra Djuric-Stefanovic ◽  
Dejan Velickovic ◽  
Ebrahimi Keramatollah ◽  
Marijan Micev ◽  
...  
Keyword(s):  
Case Report ◽  
Epigastric Pain ◽  
Gastrointestinal Stromal Tumour ◽  
Aggressive Fibromatosis ◽  
High Rate ◽  
Desmoid Tumour ◽  
Positive Staining ◽  
Beta Catenin ◽  
Palpable Mass ◽  
The Right

Aggressive fibromatosis is a rare type of intra-abdominal desmoid tumour that usually involves the small bowel mesentery. It is a locally-invasive lesion, with a high rate of recurrence, but without metastatic potential. Aggressive fibromatosis is seen more often in young female patients. This case report presents the radiological, intraoperative and histopathological findings from a 37-year-old female patient that presented with epigastric pain and a palpable mass in the right hemiabdomen. Histological and immunohistochemical examinations of the resected tumour, including positive staining for beta-catenin, confirmed a postoperative diagnosis of desmoid type fibromatosis. This specific case showed that desmoid type fibromatosis of the colon can mimic gastrointestinal stromal tumours (GIST) based on its clinical presentation, computed tomography and magnetic resonance imaging findings. Differential diagnosis between desmoid type fibromatosis and GIST is clinically very important due to the different treatments and follow-up protocols that are implemented for these lesions.

Intra-abdominal fibroid lesion of colonic involvement

2021 ◽  
Vol 15 (7) ◽  
pp. 1672-1675
Author(s):  
Muhammad Awais ◽  
Sundas Javeed ◽  
Mahnoor Mohydin ◽  
M. Kamil Zulfiquar ◽  
Usama Rafi ◽  
...  
Keyword(s):  
Uterine Fibroids ◽  
Lower Abdominal Pain ◽  
Aggressive Fibromatosis ◽  
Right Hemicolectomy ◽  
Desmoid Tumour ◽  
Team Approach ◽  
Colonic Wall ◽  
Colonic Involvement ◽  
Desmoid Tumours ◽  
History Of

Fibroid is a benign lump of growth, occurring within or outside the uterus. It is a rarity for such growths to occur intra-abdominally. Such cases are of aggressive fibromatosis which are marked by the presence of desmoid tumours. It is most commonly seen in patients with a history of familial adenomatous polyposis (FAP) or past surgical procedures. As FAP has a wide fibroepithelial growth spectrum, the symptomatology and therefore the prognosis varies. Unpredictable clinical behaviour, varied location and non-specific presentation are the factors accounting to diagnostic difficulty. Therefore, misdiagnosing the disease is not uncommon. Here we report a case ofa26-year-old pregnant female presenting with lower abdominal pain and mass. Preoperative diagnosis was of uterine fibroids as per radiological evidence, but on exploration it turned out to be a large right colonic mass. The patient underwent right hemicolectomy. Histopathological reports confirmed morphological and immuno-histochemical features indicating fibromatosis. This fibromatous mass though intra-abdominal was not growing from the mesentery/mesocolon or the pelvis. It appeared to grow from the wall of the colon. This is a confirmatory presentation of true colonic wall fibromatosis which is deep and isolated form of intra-abdominal desmoid tumours. As this lesion was isolated in nature, the treatment of choice was surgical resection. It is essential to have a multi-disciplinary team approach in the management of such a patient. This improves the treatment and the prognostic outcomes. Keywords: Fibroid, Colon, Fibromatosis, Hemicolectomy, Desmoid Tumour

CASE REPORT: ENDOMETRIAL STROMAL SARCOMA AND LIPOSARCOMA IN AN AFRICAN HEDGEHOG (Atelerix albiventris)

2016 ◽  
Vol 42 (03) ◽  
pp. 181-186 ◽  
Author(s):  
Fang-Yi Tsai ◽  
Hui-Ming Chang ◽  
Hao-Kai Chang ◽  
Ju-Pai Kao ◽  
Jiunn-Wang Liao
Keyword(s):  
Smooth Muscle Actin ◽  
Abdominal Mass ◽  
Endometrial Stromal Sarcoma ◽  
Surgical Excision ◽  
Exploratory Laparotomy ◽  
Species Interaction ◽  
Neoplastic Cells ◽  
Stromal Sarcoma ◽  
Subcutaneous Mass ◽  
The Right

A 2-year-7-month-old female intact African hedgehog was presented with a subcutaneous mass around the right side of the neck as well as an intra-abdominal mass found during palpation. Surgical excision and exploratory laparotomy were performed. A uterine mass was identified during laparotomy and ovariohysterectomy was performed. The botryoid mass measured [Formula: see text][Formula: see text]cm and was located in the right uterine horn. It had a meat-like texture and was yellow-white and dark red in color. The removed subcutaneous mass measured [Formula: see text][Formula: see text]cm. The mass was well-encapsulated and had a yellow-white homogeneous texture on the cut surface. Histologically, the myometrium was invaded by neoplastic cells and the tissue boundaries were not obvious. Neoplastic cells were arranged in a whirling or intersecting pattern, with strong angiogenesis present. Vacuolated nuclei were round and oval to cigar shaped, with one to multiple nucleoli present. Immunohistochemistry revealed a positive reaction for CD10, but a negative reaction for smooth muscle actin (SMA) and desmin in the uterine neoplastic cells. Histologically, well-differentiated adipocytes with sheets of undifferentiated polygonal neoplastic cells, which were characterized by vacuolated nuclei with prominent multiple nucleoli, were found in the subcutaneous mass. Neoplastic cells of the subcutaneous mass were positively stained with antibodies of MDM2 and estrogen receptor (ER), but failed to give a positive result for vimentin because the cross-species interaction was insufficient. The definitive diagnosis was endometrial stromal sarcoma and liposarcoma in an African hedgehog.

scholarly journals Spontaneous mesenteric hematoma after antiplatelet therapy: a case report

2018 ◽  
Vol 5 (6) ◽  
pp. 2346
Author(s):  
Chen Liang ◽  
Kazuhiro Takahashi ◽  
Kinji Furuya ◽  
Mai Sakashita ◽  
Shingo Sakashita ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Sigmoid Colon ◽  
Antiplatelet Therapy ◽  
Abdominal Mass ◽  
Exploratory Laparotomy ◽  
Emergency Laparotomy ◽  
Pathology Report ◽  
Mesenteric Vessel ◽  
Abdominopelvic Ct ◽  
Mesenteric Hematoma

Spontaneous mesenteric hematoma (SMH) is one of the rare conditions with abdominal mass secondary to hemorrhage. It develops due to regional bleeding in the mesenteric vessel of a gastrointestinal tract. The unusual morphology and lack of apparent etiology of SMH make it difficult to diagnose. A 57-year-old woman was referred to our hospital for intermittent abdominal pain with nausea and vomiting. She was receiving antiplatelet therapy by aspirin from idiopathic thrombocytosis. The number of platelet was above the normal level. CT showed a tumor-like lesion with arterial extravasation in the left lower abdomen. Mesenteric hematoma was considered since the mass was located between two branches of inferior sigmoid artery (IMA). Emergency laparotomy was performed and a mesenteric hematoma adjacent to the sigmoid colon was identified. The mesenteric hematoma was resected with the regional sigmoid colon. Pathology report showed intact mucous membrane of the excision without tumors or aneurysm. SMH was finally confirmed. The patient returned to her daily life without complaining of any symptoms. When a patient on antiplatelet therapy complained of acute abdominal pain, SMH has to be taken into consideration. Abdominopelvic CT scan is an effective investigation for diagnosis, and conservative therapy or emergent exploratory laparotomy could be an optional treatment. To the best of our research in Medline, there have only seven cases of colorectal SMH. Authors reportrd a rare case of SMH located at sigmoid colon, which appeared after antiplatelet therapy. 

scholarly journals Large intraperitoneal lipoleiomyoma in a pre-menopausal woman: a case report

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Sara L. Schaefer ◽  
Amy L. Strong ◽  
Sheena Bahroloomi ◽  
Jichang Han ◽  
Michella K. Whisman ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Smooth Muscle ◽  
Case Report ◽  
Smooth Muscle Actin ◽  
Abdominal Mass ◽  
Histopathological Analysis ◽  
Menopausal Woman ◽  
En Bloc ◽  
Cross Sectional

Abstract Background Lipoleiomyoma is a rare, benign variant of the commonplace uterine leiomyoma. Unlike leiomyoma, these tumors are composed of smooth muscle cells admixed with mature adipose tissue. While rare, they are most frequently identified in the uterus, but even more infrequently have been described in extrauterine locations. Case presentation We describe a case report of a 45-year-old woman with a history of in vitro fertilization pregnancy presenting 6 years later with abdominal distention and weight loss found to have a 30-cm intra-abdominal lipoleiomyoma. While cross-sectional imaging can narrow the differential diagnosis, histopathological analysis with stains positive for smooth muscle actin, desmin, and estrogen receptor, but negative for HMB-45 confirms the diagnosis of lipoleiomyoma. The large encapsulated tumor was resected en bloc. The patients post-operative course was uneventful and her symptoms resolved. Conclusions Lipoleiomyoma should be considered on the differential diagnosis in a woman with a large intra-abdominal mass. While considered benign, resection should be considered if the mass is symptomatic, and the diagnosis is unclear or there is a concern for malignancy.

scholarly journals Clinicopathological features and differential diagnosis of gastrofibromatosis-like undifferentiated carcinoma

2020 ◽  
Vol 48 (12) ◽  
pp. 030006052097446
Author(s):  
Zhishang Zhang ◽  
Guang Zhao ◽  
Bo Jiang ◽  
Baohui Li ◽  
Yangkun Wang
Keyword(s):  
Differential Diagnosis ◽  
Gene Amplification ◽  
Smooth Muscle Actin ◽  
Growth Factor Receptor ◽  
Aggressive Fibromatosis ◽  
Undifferentiated Carcinoma ◽  
Clinicopathological Features ◽  
Gastric Body ◽  
Her2 Gene ◽  
Her2 Gene Amplification

Objective To study the clinicopathological features and differential diagnosis of gastrofibromatosis-like undifferentiated carcinoma (GFLUC). Methods Three patients with GFLUC underwent histological and immunophenotypic analyses and fluorescence in situ hybridization to detect human epidermal growth factor receptor ( HER2) gene amplification. Results Among the three patients (2 male [36 and 44 years old], 1 female [58 years old]), two had lesions in the gastric body and one had lesions in the gastric antrum. Histological analysis revealed mixtures of aggressive fibromatosis and undifferentiated carcinoma in all three cases. Highly invasive fibromatous tissue, consisting of fibroblasts, proliferating myofibroblasts, and collagenous fibrous tissues, accounted for >90% of the tumor, with undifferentiated cancerous tissue accounting for <10% scattered in the gaps within the invasive fibromatous tissue, with no glandular ducts or nests. Immunophenotypic analysis showed that the undifferentiated cancerous cells were positive for pan-cytokeratin, CDX2, villin, and p53, while the cytoplasm of invasive fibromatous cells was positive for vimentin, β-catenin, and smooth muscle actin. No HER2 gene amplification was detected. Conclusions Unlike other gastric carcinomas, GFLUC shows specific histological, biological, and immunophenotypic characteristics.

A Rare Cause of Mechanical Intestinal Obstruction: A Neoplastic Intra-Abdominal Testis

2016 ◽  
Vol 101 (3-4) ◽  
pp. 167-170
Author(s):  
Fatih Ciftci ◽  
Suat Benek ◽  
Cem Kezer
Keyword(s):  
Intestinal Obstruction ◽  
Acute Abdomen ◽  
Undescended Testis ◽  
Abdominal Mass ◽  
Relevant Literature ◽  
Large Diameter ◽  
Exploratory Laparotomy ◽  
Clinical Findings ◽  
Surgical Units ◽  
Mechanical Intestinal Obstruction

The acute abdomen has many etiologies frequently encountered in emergency surgical units. Approximately 20% of surgical admissions for acute abdominal conditions are for intestinal obstruction. Clinicians often overlook rarer causes. A 43-year-old man presented to the emergency ward with the clinical findings of ileus. Computed tomography revealed a heterogeneous necrotic 168 × 100-mm mass between the sigmoid colon and urinary bladder. Physical examination revealed a palpable intra-abdominal mass that was removed via exploratory laparotomy. On histopathologic examination, the mass was identified as a seminoma. The literature contains few reports of seminoma as a cause of acute abdomen and ileus, mostly seen between the ages of 30 and 40 years. We report a patient with seminoma arising in an undescended testis that presented as a palpable painful lower abdominal mass and mechanical intestinal obstruction, despite the large diameter of the mass, as well as review relevant literature.

scholarly journals Congenital Descending Colonic Stenosis with Perforation of Transverse Colon in a Neonate: A Case Report

2012 ◽  
Vol 32 (1) ◽  
pp. 73-75
Author(s):  
R Hamid ◽  
AH Shera ◽  
NA Bhat ◽  
A Baba ◽  
A Rashid
Keyword(s):  
Intestinal Obstruction ◽  
Sigmoid Colon ◽  
Transverse Colon ◽  
Late Onset ◽  
Abdominal Distension ◽  
Exploratory Laparotomy ◽  
Uneventful Recovery ◽  
Colonic Stenosis ◽  
Colonic Atresia ◽  
Mucous Fistula

Colonic atresia and stenosis are rare causes of intestinal obstruction in the infant. Only 10 cases have been reported in Literature since 1966 and only one late-onset case has been reported in Literature until now. We describe the case of a 3 day old baby presenting with abdominal distension, failure to pass meconium and vomiting. X-ray of the abdomen showed dilated gut loops. Exploratory laparotomy was performed. At the junction of descending and sigmoid colon a stenosis was found, laparotomy also revealed a perforation of transverse colon. Transverse colostomy and a mucous fistula of sigmoid colon was performed after resecting stenosing segment and colon distal to perforation site upto stenosing site. Diagnosis was confirmed on histopathology. Colostomy was close after six weaks with uneventful recovery. Considering both the Literature and our case, congenital colonic stenosis should be considered one of the rare differential diagnoses in a neonate presenting as complete or partial intestinal obstruction. Key words: Colonic Stenosis; Perforation; Obstruction DOI: http://dx.doi.org/10.3126/jnps.v32i1.5446   J. Nepal Paediatr. Soc. Vol.32(1) 2012 73-75  

scholarly journals MUCINOUS CYSTADENOCARCINOMA

2018 ◽  
Vol 16 (2) ◽  
pp. 59
Author(s):  
Sadia Anwar ◽  
Nasim Saba
Keyword(s):  
Abdominal Mass ◽  
Exploratory Laparotomy ◽  
Abdominal Hysterectomy ◽  
Genetic Mutation ◽  
Cystic Mass ◽  
Mucinous Cystadenocarcinoma ◽  
Ca 125 ◽  
Invasive Adenocarcinoma ◽  
Epithelial Tumor ◽  
Glandular Cells

A 55 years old lady presented to Gynecology outpatient of MMM Teaching Hospital, D.I.Khan in January 2018 with history of abdominal mass. Her abdominal hysterectomy was done one year back. On examination a huge cystic mass reaching up to the xiphisternum and occupying the whole abdomen was palpable. Her ultrasound revealed a mass arising from pelvis, most likely ovarian in nature. Her CA-125 level was 29.62 IU/ml (in normal range). Exploratory laparotomy revealed a huge cystic mass which was excised. Histopathology reported mucinous cystadenocarcinoma of the ovary. Chemotherapy was then done. There was no recurrence by the end of nine months follow-up as evaluated by ultrasonography. Mucinous cystadenocarcinoma is an invasive adenocarcinoma composed of malignant glandular cells containing intracytoplasmic mucin. It is relatively common in middle-aged women. Genetic mutation such as KRAS gene have been reported. It is a rapidly growing epithelial tumor usually presenting as a single solid mass. Treatment involves surgery and chemotherapy. The prognosis depends upon the stage of tumor.

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