Desmoid-type Fibromatosis after Laparoscopic Endoscopic Co-operative Surgery for a Gastrointestinal Stromal Tumor of Stomach—A Case Report—

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  • ONISHI Toshio
    Department of Gastroenterologic Surgery, Kanazawa Medical University
  • KINAMI Shinichi
    Department of Gastroenterologic Surgery, Kanazawa Medical University
  • TOMITA Yasuto
    Department of Gastroenterologic Surgery, Kanazawa Medical University
  • FUJITA Hideto
    Department of Gastroenterologic Surgery, Kanazawa Medical University
  • UEDA Nobuhiko
    Department of Gastroenterologic Surgery, Kanazawa Medical University
  • KOSAKA Takeo
    Department of Gastroenterologic Surgery, Kanazawa Medical University

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Other Title
  • 腫瘍中心に迷入膵組織が認められた胃GIST切除後デスモイド腫瘍の1例
  • 症例 腫瘍中心に迷入膵組織が認められた胃GIST切除後デスモイド腫瘍の1例
  • ショウレイ シュヨウ チュウシン ニ メイニュウスイソシキ ガ ミトメラレタ イ GIST セツジョ ゴ デスモイド シュヨウ ノ 1レイ

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Abstract

A 75-year-old woman was diagnosed as having a gastrointestinal stromal tumor (GIST) in the stomach and underwent laparoscopic endoscopic co-operative surgery (LECS). X-ray and computed tomography (CT) examination during follow-up on an outpatient basis, revealed a mass on the side of the lesser curvature of the stomach. A follow up CT showed an increased tumor diameter, and she was diagnosed as having a recurrence of GIST. She underwent a second surgery a year after the initial operation. A tumor covered by peritoneum was confirmed in the lesser omentum at the gastric angle along the lesser curvature and the tumor was resected. The resected specimen was a 20×14×12 mm grayish white mass with a clear border. Histologically, an irregular cluster of fibroblast-like spindle-shaped cells was observed, accompanied by inflammatory cell infiltrates. Furthermore, β-catenin positivity by immunostaining confirmed a diagnosis of desmoid-type fibromatosis.<BR>Additionally, pancreatic cells comprising acinar cells and islets of Langerhans confirmed at the center of the tumor, led to a diagnosis of an aberrant pancreas. There are some reports of the development of desmoid tumors after resection of GIST in the stomach, but desmoid tumors with aberrant pancreas in the center have not been reported. We report a case of mesenteric desmoid tumor with rare morphology and an accompanying aberrant pancreas.

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