肠系膜侵袭性纤维瘤病:病例报告及文献复习OA

Objective To explore the diagnosis,treatment,and research progress of mesenteric aggressive fibromatosis(AF)by reporting a case of AF encasing the superior mesenteric artery(SMA)and reviewing the literature.Methods A retrospective analysis was conducted on the clinical data of a 40-year-old female patient with mesenteric AF,who presented with an abdominal mass and abdominal distension for more than 2 months.Physical examination revealed a firm,poorly mobile,massive mass in the left upper abdomen.Imaging revealed a massive intra-abdominal space-occupying lesion encasing the SMA.The clinical manifestations,laboratory and imaging findings,multidisciplinary preoperative evaluation,surgical procedures,pathological results,and follow-up data were systematically collected.Additionally,relevant literature was retrieved and similar cases were summarized to explore the diagnostic and therapeutic approaches for this condition.Results The patient underwent surgical resection of the mass and partial jejunum combined with SMA reconstruction after multidisciplinary evaluation.Histopathological examination confirmed mesenteric AF with negative surgical margins.During the 6-month follow-up,computed tomography angiography(CTA)showed unobstructed blood flow of the SMA,and no tumor recurrence or metastasis was observed.The literature review included this case and 9 reported cases,totaling10 cases:7 males and3 females,with an average age of 43.2 years(range,27 to 69 years).Tumor locations included the small intestinal mesentery(5 cases),ileocecal mesentery(1 case),colorectal mesentery(2 cases),and unknown mesenteric sites(2 cases).All patients received surgical treat-ment.One patient died on the first postoperative day,the prognosis of 2 patients was unknown,and the remaining patients had generally favorable outcomes during follow-up.Conclusions AF is a rare borderline soft tissue tumor.The intra-abdominal subtype is particularly uncommon and poses substantial challenges in diagnosis and management.Individualized treatment strategies should be formulated based on tumor type and size.For mesen-teric AF involving the SMA,organ-sparing radical resection combined with vascular reconstruction is a safe and feasible approach.