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Radical resection of a giant retroperitoneal calcifying fibrous tumor combined with right hepatectomy and reconstruction of the inferior vena cava and bilateral renal veins

机译:巨大腹膜后钙化纤维瘤的根治性切除结合右肝切除术及下腔静脉和双侧肾静脉的重建

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BackgroundWe report a case of a giant retroperitoneal calcifying fibrous tumor (CFT) treated by radical tumor resection combined with right hepatectomy and reconstruction of the inferior vena cava (IVC) and bilateral renal veins. Only three case reports of CFT arising in the retroperitoneum have been reported until today. Case presentationIn a 19-year-old female patient, computed tomography (CT) images showed a well-demarcated expansile lesion around the IVC accompanied by focal calcification, whereas the IVC that was circumferentially surrounded by the lesion was dilated due to the desmoplastic reaction. On magnetic resonance imaging (MRI), the lesion demonstrated heterogeneous hypointensity on T2-weighted images. Delayed enhancement was observed on dynamic contrast-enhanced CT and MRI. 18F-Fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT images showed increased FDG uptake [maximum standardized uptake values (SUVmax), early image 7.28; delayed image 7.40]. On operative examination, because the tumor adhered to the liver parenchyma, the right Glisson capsule, and the origin of bilateral renal veins, radical tumor resection combined with right hepatectomy and reconstruction of the IVC and bilateral renal veins was performed. ConclusionsRadical tumor resection was successfully and appropriately performed for a young patient with a giant retroperitoneal CFT with a view to achieving complete venous reconstruction and safe surgical margins for a potentially malignant tumor.
机译:背景我们报道了一例巨大的腹膜后钙化纤维性肿瘤(CFT),通过根治性肿瘤切除,右肝切除以及下腔静脉(IVC)和双侧肾静脉的重建治疗。迄今为止,仅报道了三例腹膜后发生CFT的病例报告。病例介绍在一名19岁的女性患者中,计算机断层扫描(CT)图像显示IVC周围有明显界限的扩张性病变并伴有局灶性钙化,而病变周围环绕的IVC由于增生反应而扩大了。在磁共振成像(MRI)上,病变在T2加权图像上显示出异质性低血压。在动态对比增强的CT和MRI上观察到延迟增强。 18 F-氟脱氧葡萄糖(FDG)正电子发射断层扫描(PET)/ CT图像显示FDG摄取增加[最大标准化摄取值(SUVmax),早期图像7.28;延迟图片7.40]。在手术检查中,由于肿瘤粘附于肝实质,右格里森囊以及双侧肾静脉的起源,因此进行了根治性肿瘤切除,右肝切除术,IVC和双侧肾静脉的重建。结论对于一位巨大的腹膜后CFT的年轻患者,成功并适当地进行了根治性肿瘤切除术,以期为潜在的恶性肿瘤实现完整的静脉重建和安全的手术切缘。

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