2019 Volume 39 Issue 1 Pages 123-127
The patient was a 48-year-old man admitted to our hospital with the chief complaints of fever and epigastric pain. Contrast-enhanced abdominal computed tomography （CT） revealed a tumor with an 80-mm abscess in contact with the stomach and transverse colon. Following drainage of the abscess, endoscopic ultrasound was performed and the patient was diagnosed as having a primary gastric submucosal tumor. Laparotomy was performed, and the tumor was removed based on the intraoperative findings by local excision of the stomach and partial resection of the transverse colon, along with combined resection of a part of the rectus abdominis muscle. Histopathological examination of the resected specimen revealed that the tumor was composed of spindle cells showing positive nuclear staining for β-catenin, and we made the diagnosis of intraperitoneal mesenteric desmoid tumor. Surgical resection is considered as the first treatment option for desmoid tumors as they show a propensity for malignant transformation. However, desmoid tumors are also known to be associated with a high risk of local recurrence, necessitating sufficient postoperative follow-up. Desmoid tumors are rare ; in particular, there have been few reports on intraperitoneal mesenteric desmoid tumors without any associated factors, with only 18 reports from Japan. Among these, the tumor was associated with peritonitis in only 3 cases, including our case presented here.
