Ann Surg Treat Res.  2014 Dec;87(6):331-335. 10.4174/astr.2014.87.6.331.

Intra-abdominal fibromatosis after gastrectomy for gastric cancer

• Kim PS
• Han DS
• Han HS
• Bang HY

• KMID: 2167090
• DOI: http://doi.org/10.4174/astr.2014.87.6.331

Abstract

Intra-abdominal fibromatosis (IAF) may arise either sporadically or in association with familial adenomatous polyposis. The characteristics of fibromatosis are slow-growth, benign histological features, and aggressive local invasion. Surgery remains a reasonable first treatment option. Here, we report 2 cases of a phenomenon rarely described in published literature, IAF after gastrectomy for gastric cancer. Intra-abdominal masses were found during the routine follow-up period in a 50-year-old man who had received a radical subtotal gastrectomy for early gastric cancer. Two mesenteric masses were detected in the upper abdomen by CT and were excised completely along with segments of the jejunum. Another intra-abdominal mass was found in 60-year-old man who had received a radical total gastrectomy for advanced gastric cancer. A 4.2-cm-sized mass was detected in the periumbilical region by follow-up CT and was excised completely along with a segment of the ileum.

Keyword

Fibromatosis; Desmoid; Gastrectomy; Stomach neoplasms

MeSH Terms

Abdomen
Adenomatous Polyposis Coli
Fibroma*
Fibromatosis, Aggressive
Follow-Up Studies
Gastrectomy*
Humans
Ileum
Jejunum
Middle Aged
Stomach Neoplasms*

Figure

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  Fig. 1 First tumor in the mesentery of the jejunum near the gastrojejunostomy site (black arrow, mesenteric mass; blue arrow, gastrojejunostomy site).

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  Fig. 2 Second tumor in the mesentery of the jejunum (black arrow, mesenteric mass; red arrow, jejunojejunostomy site).

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  Fig. 3 Second tumor in the mesentery of the jejunum before the jejunum was resected.

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  Fig. 4 A 4.2-cm-sized mass in the periumbilical region by CT: (A) horizontal view (red arrow, mesentery mass), (B) coronal view (red arrows, mesentery mass).

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  Fig. 5 Mild hypermetabolic mass in the periumbilical region by PET/CT (red arrow, mesenteric mass).

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  Fig. 6 Mesenteric mass and ileum excised completely. (A) resected specimen. (B) cross-sectional view.

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  Fig. 7 Histologically, proliferation of spindle-shaped cells with uniform cytologic features and focal dense collagen deposition is seen (H&E, ×100).

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  Fig. 8 Immunohistochemically, the tumor cells showed diffuse β-catenin nuclear staining (×200).

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