Advertisement

Diseases of the Colon & Rectum

, Volume 43, Issue 5, pp 713–716 | Cite as

Successful resection of an ileoanal pouch mesenteric desmoid without pouch sacrifice

Report of a case
  • Richard J. Guy
  • Neil J. McC. Mortensen
Case Reports
  • 11 Downloads

Abstract

PURPOSE: Intra-abdominal desmoid tumors are associated with familial adenomatous polyposis and may compromise ileoanal pouch function after restorative proctocolectomy, particularly if the pouch mesentery is involved. This usually necessitates pouch excision. The aim of this report was to describe the first known case of pouch salvage after surgery for a desmoid tumor arising from the pouch mesentery. METHODS: The management of a desmoid tumor involving an ileoanal pouch in a 21-year-old female is described and the literature reviewed. RESULTS: The tumor was successfully excised completely after failed medical therapy, and pouch function was fully preserved. CONCLUSIONS: This is a unique case highlighting the possibility of pouch salvage when affected by desmoid tumor.

Key words

Familial adenomatous polyposis Restorative proctocolectomy Ileoanal pouch Desmoid tumor 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Smith WG. Multiple polyposis, Gardner's syndrome and desmoid tumours. Dis Colon Rectum 1958;1:323–32.PubMedGoogle Scholar
  2. 2.
    Jones IT, Jagelman DG, Fazio VW, Lavery IC, Weakley FL, McGannon E. Desmoid tumors in familial polyposis coli. Ann Surg 1986;204:94–7.PubMedGoogle Scholar
  3. 3.
    Klemmer S, Pascoe L, DeCosse J. Occurrence of desmoids in patients with familial adenomatous polyposis of the colon. Am J Med Genet 1987;28:385–92.CrossRefPubMedGoogle Scholar
  4. 4.
    Lotfi AM, Dozois RR, Gordon H,et al. Mesenteric fibromatosis complicating familial adenomatous polyposis: predisposing factors and results of treatment. Int J Colorectal Dis 1989;4:30–6.CrossRefPubMedGoogle Scholar
  5. 5.
    Arvanitis ML, Jagelman DG, Fazio VW, Lavery IC, McGannon E. Mortality in patients with familial adenomatous polyposis. Dis Colon Rectum 1990;33:639–42.PubMedGoogle Scholar
  6. 6.
    Penna C, Tiret F, Parc R,et al. Operation and abdominal desmoid tumors in familial adenomatous polyposis. Surg Gynecol Obstet 1993;177:263–8.PubMedGoogle Scholar
  7. 7.
    Hanson IM, Guest PJ, Keighley MR, Sanders DS. Mesenteric fibromatosis (desmoid tumour) complicating restorative proctocolectomy for familial adenomatous polyposis. Illustrated Case Rep Gastroenterol 1997;4:101–4.Google Scholar
  8. 8.
    Sagar PM, Möslein G, Dozois RR. Management of desmoid tumors in patients after ileal pouch-anal anastomosis for familial adenomatous polyposis. Dis Colon Rectum 1998;41:1350–6.CrossRefPubMedGoogle Scholar
  9. 9.
    Heiskanen I, Järvinen HJ. Occurrence of desmoid tumors in familial adenomatous polyposis and results of treatment. Int J Colorectal Dis 1996;4:157–62.CrossRefGoogle Scholar
  10. 10.
    Khorsand J, Karakousis CP. Desmoid tumors and their management. Am J Surg 1985;149:215–8.PubMedGoogle Scholar
  11. 11.
    Gurbuz AK, Giardiello FM, Petersen GM,et al. Desmoid tumors in familial adenomatous polyposis. Gut 1994;35:377–81.PubMedGoogle Scholar
  12. 12.
    Reitamo JJ, Hayry P, Nykyri E, Saxen E. The desmoid tumor I. Incidence, sex, age and anatomical distribution in the Finnish population. Am J Clin Pathol 1982;77:665–73.PubMedGoogle Scholar
  13. 13.
    Belliveau P, Graham AM. Mesenteric desmoid tumor in Gardner's syndrome treated by sulindac. Dis Colon Rectum 1984;27:53–4.PubMedGoogle Scholar
  14. 14.
    Klein WA, Miller HH, Anderson M, DeCosse JJ. The use of indomethacin, sulindac and tamoxifen for the treatment of desmoid tumors associated with familial polyposis. Cancer 1987;60:2863–8.PubMedGoogle Scholar
  15. 15.
    Tsukada K, Church JM, Jagelman DG,et al. Noncytotoxic drug therapy for intra-abdominal desmoid tumor in patients with familial adenomatous polyposis. Dis Colon rectum 1992;35:29–33.CrossRefPubMedGoogle Scholar
  16. 16.
    Eagel BA, Zentler-Munro P, Smith IE. Mesenteric desmoid tumors in Gardner's syndrome-review of medical treatments. Postgrad Med J 1989;65:497–501.PubMedGoogle Scholar
  17. 17.
    Brooks MD, Ebbs SR, Colletta AA, Baum M. Desmoid tumors treated with triphenylethylenes. Eur J Cancer 1992;28A:1014–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Posner MC, Shiu MH, Newsome JL, Hajdu SI, Gaynor JJ, Brennan MF. The desmoid tumor. Not a benign disease. Arch Surg 1989;124:191–6.PubMedGoogle Scholar
  19. 19.
    Sherman NE, Romsdahl M, Evans H, Zagars G, Oswald MJ. Desmoid tumors: a 20-year radiotherapy experience. Int J Radiat Oncol Biol Phys 1990;19:37–40.PubMedGoogle Scholar
  20. 20.
    Patel SR, Evans HL, Benjamin RS. Combination chemotherapy in adult desmoid tumors. Cancer 1993;72:3244–7.PubMedGoogle Scholar
  21. 21.
    Lynch HT, Fitzgibbons R Jr, Chong S,et al. Use of doxorubicin and dacarbazine for the management of unresectable intra-abdominal desmoid tumors in Gardner's syndrome. Dis Colon Rectum 1994;37:260–7.CrossRefPubMedGoogle Scholar
  22. 22.
    Järvinen HJ. Desmoid disease as a part of familial adenomatous polyposis coli. Acta Chir Scand 1987;153:379–83.PubMedGoogle Scholar
  23. 23.
    Burke AP, Sobin LH, Shekitka KM, Federspiel BH, Helwig E. Intra-abdominal fibromatosis: a pathological analysis of 130 tumors with comparison of clinical subgroups. Am J Surg Pathol 1990;14:335–41.PubMedGoogle Scholar

Copyright information

© American Society of Colon and Rectal Surgeons 2000

Authors and Affiliations

  • Richard J. Guy
    • 1
  • Neil J. McC. Mortensen
    • 1
  1. 1.From the Department of Colorectal SurgeryJohn Radcliffe HospitalHeadington, OxfordUnited Kingdom

Personalised recommendations