M.I.M.G., female patient, 42 years old.
She had a history of seizures and right inguinal hernioplasty.
She suffered from abdominal pain in November 2003.
An ultrasound scan showed a 1 cm hepatic nodule (probable hemangioma) and a vesicular polyp of 1 cm. The patient persisted with pain in the right hypochondrium and was consulted again.
An echotomography was requested on March 24, 2004, which showed a tumor of the mesentery of fat density, with an image suggestive of lymph nodes in its thickness, of 8.5 x 3 x 6 cm lymphoproliferative process.
Abdominal computed axial tomography (CAT) (25.03.04) confirmed the gallbladder polyp of 1 cm and the existence of two hepatic hemangiomas.
There was a solid tumor of the root of the mesentery, with some fatty foci inside, surrounded by intestinal loops.
The intestinal transit confirmed the displacement of the intestinal loops by a mass effect, without alteration of the mucosal relief.
Magnetic resonance imaging showed a solid tumor mass from the root of the mesentery on 26.03.04, suggesting a primary tumor as the first possibility (lymphoma, sarcoma, etc.).
He had negative tumor markers (CA19-9, CA 125, a fetoprotein, CEA).
A solid lesion of the mesentery of the ileum of approximately 9 cm in diameter was detected in the exploration. It reached the mesenteric vessels of the right ileolipteral anastomosis of the ileoileum and resection of the right colon.
Rapid biopsy: fibrotic abdominal tumor of character.
1.
Definitive biopsy result: Fibromatosis type (Intraabdominal Desmoid Tumor).
In the mesentery an 8 x 6 x 4 cm tumor of brown-violaceous surface was recognized, with fibrous adhesions.
Cutting showed whitish-white deposits, fasciculate part.
It was located at the root of the mesentery.
Microscopically, it consisted of proliferation of spindle cells arranged uniformly in a collagenous dense stroma.
Very few mitosis were observed.
The lesion was located in adipose tissue of the mesentery, vessels and right ureter.
1.
Gallbladder biopsy: Cholesteroluria (2).
Healing was favorable in the postoperative period, affliction, with good healing and no evident complications.
13.4.04.
Controls were unchanged from July 2004.
