A Resected Case of a Mesenteric Desmoid Tumor that Invaded the Uncinate Process of the Pancreas and Required Resection and Reconstruction of the Superior Mesenteric Vein

Abstract

A 58-year-old man presented with an abdominal mass. A contrast-enhanced CT scan showed a 12-cm solid mass on the uncinate process of the pancreas and caudal side of the duodenum ; the superior mesenteric vein (SMV) had been occluded by the tumor at the distal portion of the second jejunal vein (J2V) junction. Laparotomy revealed the tumor to have occupied the inside of the mesentery and to be adherent to the uncinate process and the third part of duodenum. We performed partial resection of uncinate process and duodenum, right hemicolectomy, resection of the SMV distal from the first jejunal vein (J1V) junction. The J2V was reconstructed to maintain the small intestinal venous return. Histopathologically, the tumor was diagnosed as a desmoid tumor. It was a huge desmoid tumor arisen from an anatomically complicated area and invaded the surrounding organs, but it was completely removed by just enough combined resections and reconstruction. The postoperative course was satisfactory, and he has been alive without recurrence as of 5 years and 10 months after the surgery.