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Wednesday, March 11, 2015

Huge abdominal tumor in a 43-year-old man


Solitary fibrous tumors are rare neoplasms that usually affect the pleura. On occasion, they can also occur in extrapleural tissues, such as the peritoneum, pericardium, anus, and paranasal sinuses. The benign form of this tumor is 3 to 4 times more common than the malignant form. The clinical manifestations depend on the size and location of the lesion. The mean age of patients at presentation is 54 years.

Solitary fibrous tumors of the peritoneum are extremely rare. Preoperative diagnosis is difficult, since several other neoplasms can give similar symptoms. A 43-year-old man in Tunisia had the misfortune to suffer from a very large abdominal tumor of this type. He sought medical help because of chronic stomach pain, abdominal fullness, and vomiting episodes, especially after heavy meals. His family and medical history were unremarkable. He had no history of previous abdominal surgery. On physical examination, a hard mass was palpated deeply in the abdomen. It was not tender, and bowel sounds were normal.



CT scan image showing a huge abdominal mass.


Laparotomy was performed and a huge, encapsulated tumor was found. It did not adhere to the wall of the stomach, liver parenchyma or adjacent structures. The surgeon was able to carefully remove the entire mass without having to resect the intestines. After removal, the tumor was found to measure 40 × 14× 20 cm. Its cut surface showed lobulated white and yellowish-brown areas.

Histologic features indicated that the mass, despite its size, was a benign solitary fibrous tumor of the peritoneum. After surgery, the patient recovered with no complications. The story ends on a positive note: no evidence of recurrence or metastasis was observed after 36 months.





Huge peritoneal tumor after resection: a 40 × 14× 20 cm mass with lobulated white and yellowish-brown areas. Images from: Bouassida et al. (2012)
 


Source:


Bouassida M, Mighri MM, Becha D, Hamzaoui L, Sassi S, Azzouz MM, Touinsi H, Sassi S. (2012) Huge Abdominal Tumor: Peritoneal Solitary Fibrous Tumor. Gastrointest Cancer Res. 5(5): 179–180.



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