Leiomyoma of mesentery in a young male: a case report and review of literature

Primary tumours of mesentery are relatively rare, and its biological behaviour is unpredictable. We herein describing a case of incidentally detected mesenteric leiomyoma along with review of literature in a 19-year-old gentleman, who had a mass in the mesentery of terminal ileum, which was detected during surgery. Mesentric masses can be both solid as well as cystic. Published reports have consisted of small numbers of cases, which makes it difficult to determine the incidence of specific tumor types. Reasonable estimates of incidence ranges from 1 case per 200,000 population and in 30-40% cases they are cystic and more in females. Diagnosis is delayed unless they become symptomatic with haemorrhage, obstruction or mass per abdomen. As primary mesenteric tumors are rare, particularly in young patients, it is considered important that this type of unusual tumor be included in the differential diagnosis for mesenteric tumors. Since the biologic behaviour of mesenteric smooth muscle tumours seems to be unpredictable long term follow up is warranted.

Radiographic response of desmoplastic mesenteric lesions to peptide receptor radionuclide therapy (PRRT).

362 Background: 177Lu-dotatate PRRT is indicated in well-differentiated, SSTR+ small bowel NETs. These tumors often metastasize to mesenteric lymph nodes and produce a desmoplastic reaction, consisting of tumor cells mixed with fibrotic tissue. We hypothesized that in patients treated with 177Lu-dotatate, mesenteric tumors would remain stable even as liver tumor size changes were observed. Methods: We retrospectively reviewed the records of all patients treated with 177Lu-dotatate between 4/2018 and 12/2019. Among patients with desmoplastic mesenteric tumors and liver metastases, we evaluated changes in tumor size of mesenteric and liver lesions based on pre and post-treatment radiology reports. Due to the infrequency of objective radiographic response (ORR), any reported changes in tumor size were considered significant. Scans were subsequently reviewed by a radiologist to confirm findings. Results: 21 patients met the inclusion criteria: 9 had evidence of shrinkage of liver lesion(s), 1 report described mild progression of liver lesions, 7 described stable hepatic disease and 4 described mixed hepatic progression/response. 2 of the patients with hepatic tumor shrinkage met criteria for PR by RECIST 1.1. Desmoplastic mesenteric lesions remained unchanged in size, regardless of the changes detected on liver lesions. Conclusions: 177Lu-dotatate does not impact desmoplastic mesenteric tumors typically associated with midgut NETs. Patients whose disease is confined to desmoplastic mesenteric lesions are unlikely to respond radiographically to PRRT. Moreover, the inclusion of desmoplastic mesenteric lesions as target lesions in RECIST measurements increases rates of disease stability versus response or progression.

Nodal histiocytic sarcoma with prominent eosinophilic infiltration: expression of eotaxin-2 on tumor cells

Background Histiocytic sarcoma (HS) is a rare neoplasm showing morphological and immunophenotypic features of mature tissue histiocytes. We report a patient with nodal HS exhibiting prominent reactive eosinophilic infiltration. Case presentation A 68-year-old man presented with intermittent left lower abdominal pain and weight loss over 3 months. A computed tomography scan revealed multiple abdominal nodules. Open biopsy of the mesenteric tumors was performed for definitive diagnosis. Histologically, the tumor was comprised of a diffuse noncohesive proliferation of pleomorphic large cells, including multinucleated cells. Neoplastic cells were positive for histiocytic markers (CD68, CD163, and LIGHT) and PD-L1 but lacked markers of Langerhans cells, follicular dendritic cells, and epithelial cells. Frequent reactive inflammatory cells were intermingled in the background. Interestingly, prominent eosinophilic infiltration was also noted. Spindle neoplastic cells were prone to be present around areas with little to no eosinophilic infiltration and exhibiting fibrosis and lymphatic vessel proliferation. Conversely, polygonal neoplastic cells were prone to be present around areas with relatively large amounts of eosinophilic infiltration without fibrosis or lymphatic vessel proliferation. Immunohistochemically, the tumor cells and reactive eosinophils expressed eotaxin-2 and eotaxin-3, respectively. Conclusion We revealed that eotaxins induced the selective migration of eosinophils into tissues in this case. These eosinophils may affect the tumor remodeling and tumor biology characteristics of HS, such as fibrosis and lymphatic vessel proliferation.

Undifferentiated carcinoma of The mesentery in a 51 year old male : A case report

Mesenteric tumors are rare and consist of a heterogeneous group of lesions. Among them undifferentiatedcarcinoma of the mesentery is very rare entity. Here we present a case of undifferentiatedcarcinoma of the mesentery in a 51 year old male presented with rapidly increasing hugeabdominal lump,central abdominal pain and weight loss. Ultrasound of the whole abdomen andCT scan of whole abdomen reports were suggestive of retroperitoneal mass. The tumor wasresected and histopathology report was suggestive of malignant mesothelioma whereas immunohistochemistryreport revealed undifferentiated carcinoma of the mesentery. Journal of Surgical Sciences (2016) Vol. 20 (1) : 29-31

Undifferentiated carcinoma of the mesentery in a 51 year old male: A Case Report

Undifferentiated carcinoma is a usually aggressive, malignant epithelial neoplasm composed of atypical cells which do not display evidence of glandular, squamous, or urothelial cell differentiation.1 Mesenteric tumors are rare and consist of a heterogeneous group of lesions. Among them undifferentiated carcinoma of the mesentery is very very rare entity. Here we present a case of undifferentiated carcinoma of the mesentery in a 51 year old male admitted to the department of surgery, Shaheed Suhrawardy Medical College Hospital (ShSMCH) with rapidly increasing huge abdominal lump, central abdominal pain and weight loss. Ultrasound of the whole abdomen and CT scan of whole abdomen reports were suggestive of retroperitoneal mass. Exploratory laparotomy was done and specimen sent for histopathology. Reports were suggestive of malignant mesothelioma whereas immunohistochemistry report revealed undifferentiated carcinoma of the mesentery. To the best of our knowledge, there was no report of undifferentiated carcinoma of the mesentery in a 51 year old male from Bangladesh or any other countryJ Shaheed Suhrawardy Med Coll, December 2015, Vol.7(2); 79-81

Complete Resection of a Complicated Huge Mesenteric Lymphangioma Guided by Mesenteric Computed Tomography Angiography With Three-Dimensional Reconstruction: Report of a Case

We herein describe the case of an adult with a complicated huge lymphangioma of the small bowel mesentery. Computed tomography (CT) confirmed a 45 × 30 × 14 cm multiple and separate, mixed and solid cystic tumor without enhancement by contrast medium in the abdominal cavity. Mesenteric CT angiography with three-dimensional (3D) reconstruction showed that the tumor did not involve the first jejunal artery, although the tumor did involve the subsequent jejunal and ileal arteries and the corresponding segment of the small bowel. Under anatomic guidance based on mesenteric CT angiography with 3D reconstruction, we were able to successfully excise the tumor. Mesenteric lymphangioma should be excised even when the tumor is asymptomatic. Mesenteric CT angiography with 3D reconstruction is useful for the surgical treatment of huge mesenteric tumors.

The role of laparoscopy in gynecologic oncology

In some patients and when performed by a skillful surgeon, gynecologic oncologist familiar with advanced laparoscopic techniques, laparoscopy results with less surgical trauma, reduced blood loss and hospitalization, and faster recovery. The complication rate has been found to increase as the complexity of the operation rises, but it is not higher than in open surgery. Preliminary studies show that recurrence and survival rates are comparable to those reported for patients treated by a standard abdominal approach. Future randomized trials are necessary to deal with long term recurrences and survival data and benefits of laparoscopy in management of gynecologic malignancies. At our institution 97 cancer patients underwent laparoscopic procedures, without complications: explorative and staging laparoscopies with biopsies of ovaries, peritoneal biopsies, retroperitoneal and mesenteric tumors; second look laparoscopy, ovariectomy, laparoscopic assisted vaginal hysterectomy (LAVH). Advanced ovarian cancer was found in 3 patients and laparotomy was performed. No complications were stablished.