Angiomyolipoma of the Jejunum Mimicking Metastatic Disease in a Patient with Colonic Adenocarcinoma英文文献资料.docVIP

Surgical Science, 2011, 2, 52-56 doi:10.4236/ss.2011.22011 Published Online April 2011 (http://www.SciRP.org/journal/ss) Angiomyolipoma of the Jejunum Mimicking Metastatic Disease in a Patient with Colonic Adenocarcinoma Spyridon Miliaras , Dimosthenis Miliaras 1 2 Surgical Department, Papageorgiou Hospital, Medical School, Aristotle University, Thessaloniki, Greece Laboratory of Histology and Embryology, Medical School, Aristotle University, Thessaloniki, Greece E-mail: dmiliara@med.auth.gr 1 2 Received July 27, 2010; revised January 5, 2011; accepted March 9, 2011 Abstract Angiomyolipoma is a benign tumor most commonly arising in the kidney. Very few cases have been re- ported to be located in the small intestine. Here we report the first case located in the jejunum in a patient who was diagnosed with a colonic adenocarcinoma. In the preoperative evaluation this benign lesion was thought it might represent a metastatic nodule. Keywords: Angiomyolipoma, Colon Adenocarcinoma, Jejunum 1. Introduction abdominal films confirmed small bowel obstruction and full blood count and biochemistry were unremarkable. Conservative treatment was initiated, including intrave- nous fluids, nasogastric suction and monitoring of the vital organs. After three days of conservative treatment, although there was no clinical deterioration, the obstruc- tive ileus was not resolved and a colonoscopy was per- formed, to further investigate the etiology of obstruction, which revealed an obstructive tumor of the ileocecal valve. A preoperative CT scan of the abdomen per- formed the next day for staging purposes showed re- gional lymphadenopathy of the mesentery of the ileoce- cal region, but no hepatic metastases. However, a soft tissue mass was found in the proximal jejunum with most probable diagnosis to be metastatic implant (Figure 1(a)). In order to resolve the