胆囊单发纤维瘤:病例报告。

IF 0.7 Q4 SURGERY Surgical Case Reports Pub Date : 2024-11-18 DOI:10.1186/s40792-024-02057-8
Kiwako Sekine, Yuichi Nakaseko, Keigo Nakashima, Teppei Kamada, Junji Takahashi, Manabu Koja, Naoko Fukushima, Ryota Iwase, Teruyuki Usuba, Masaichi Ogawa, Yutaka Suzuki
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引用次数: 0

摘要

背景:胆囊原发性单发纤维性肿瘤(SFTs)非常罕见。在此,我们报告了一例因胆囊原发性单发纤维瘤而接受手术治疗的患者的病例:病例介绍:一名 70 岁的男性在一家基层医院通过腹部超声波检查发现了 48 毫米的胆囊肿瘤,随后被转诊至我科。计算机断层扫描发现胆囊内有一个 50 毫米的增强肿瘤。磁共振成像显示肿瘤边缘光滑,T2加权成像呈高密度。18F-氟脱氧葡萄糖正电子发射断层扫描证实,胆囊肿瘤早期有高水平的氟脱氧葡萄糖摄取,后期摄取量没有增加。为评估肿瘤诊断,我们计划进行手术切除。首先,我们进行了开腹胆囊切除术,并对胆囊床进行了楔形切除。术中病理检查提示为胆囊癌,因此我们进行了根治性手术,包括切除胆总管、扩大根治性淋巴结切除术和胆总管空肠吻合术。最终,病理检查显示 SFT 源自胆囊,手术切缘阴性。术后,患者出现胆汁渗漏,经管道引流治疗。患者恢复情况令人满意,并于术后第 20 天出院。术后 24 个月,患者一般状况良好,没有复发:我们报告了一例罕见的胆囊原发性 SFT 病例。临床医生应该意识到胆囊中也可能存在 SFT,当术前诊断困难时,应考虑手术治疗。
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Solitary fibrous tumor of the gallbladder: a case report.

Background: Primary solitary fibrous tumors (SFTs) of the gallbladder are rare. Here, we report the case of a patient who underwent surgical treatment for a primary SFT originating in the gallbladder.

Case presentation: A 48-mm gallbladder tumor was detected in a 70-year-old man using abdominal ultrasonography at a primary hospital, and he was subsequently referred to our department. A 50-mm enhanced tumor in the gallbladder was identified using computed tomography. Magnetic resonance imaging revealed a smooth-marginated tumor with hyperintensity on T2-weighted imaging. 18F-Fluorodeoxyglucose positron emission tomography confirmed high-level fluorodeoxyglucose uptake in the gallbladder tumor in the early phase without increasing uptake in the later phase. Surgical resection was planned to evaluate the tumor diagnosis. Initially, we performed open cholecystectomy with wedge resection of the gallbladder bed. Intraoperative pathological examination suggested gallbladder cancer; therefore, we performed radical surgery, including resection of the common bile duct, extended radical lymphadenectomy, and choledochojejunostomy. Ultimately, the final pathological examination revealed an SFT originating from the gallbladder with a negative surgical margin. Postoperatively, the patient developed bile leakage that was treated with tube drainage. The patient recovered satisfactorily and was discharged on postoperative day 20. At 24 months postoperatively, the patient was in good general condition without recurrence.

Conclusions: We report a rare case of a primary SFT originating in the gallbladder. Clinicians should be aware that SFT can be found in the gallbladder, and when it is difficult to make a preoperative diagnosis, surgical treatment should be considered.

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