omentum tumor
Introduction
Introduction to omental tumor Omental tumors can be divided into primary and secondary types, mostly metastases, and the primary site is often in the colon, stomach, pancreas or ovary. Primary retinal tumors are rare and have benign and malignant points. Benign tumors include lipoma, leiomyomas, hemangiomas, and neurofibromas. Malignant tumors include leiomyosarcoma, rhabdomyosarcoma, angioendothelioma, fibrosarcoma, and myxomas. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific people Mode of infection: non-infectious Complications: anemia, ascites
Cause
Omental tumor etiology
(1) Causes of the disease
Omental tumors include primary retinal tumors and secondary retinal tumors. Primary retinal tumors have a wide range of mesenteric tumors. 60% of retinal tumors are derived from smooth muscle, including leiomyoma and smooth muscle. Sarcoma, other benign tumors such as lipoma and neurofibroma are rare. Primary retinal tumors refer to tumors that occur in the omentum itself, rather than tumors other than the other organs or abdomen in the abdominal cavity. The results of membrane infiltration, implantation or metastasis, such as classification according to the nature of the tumor, can generally be divided into benign tumors and malignant tumors.
1. Benign tumors: leiomyomas, lymphangiomas are more common, rare benign tumors have teratomas, fibroids, lipomas, hemangioma, mesothelioma, myxomas and inflammatory pseudotumors, etc. Cysts are mostly benign lesions, most of which are caused by cystic dilatation of congenital lymphatic vessels. A few are caused by local expansion of the lymphatic vessels and cyst formation. Other rare causes are also seen in trauma, parasitic infection, etc. According to the different contents of omental cysts, scholars can be divided into blood cysts, chylorrhea cysts, serous cysts, cysticercosis cysts, dermoid cysts and cysts formed by liquefaction of tumor degeneration and necrosis. The cysts can be single or multiple. However, some scholars in China have reported that cysts are the most common in benign tumors.
2. Malignant tumors: malignant tumors originating from the omentum are rare, and most of them are sarcomas, such as leiomyosarcoma, liposarcoma, and other malignant lymphomas and malignant hemangioendothelioma, and more are transferred to the net. Membrane malignant tumors, such as gastric cancer, liver cancer, ovarian cancer, colon cancer and other intra-abdominal malignant tumors can be transferred to the omentum, the way of metastasis can be planted in the omentum after blood, lymphatic circulation or cancer cells fall off, or cancer Direct infiltration, the result of the spread.
(two) pathogenesis
Most of the omental tumors are benign, and 40% of the omental solid tumors are malignant. These malignant tumors mainly cause local infiltration and peritoneal implantation, rather than distant metastasis, but can be killed by invading major organs.
Primary retinal tumors mainly include leiomyosarcoma, rhabdomyosarcoma, liposarcoma, vascular sarcoma, fibrosarcoma and mucinous adenocarcinoma; benign tumors include lipoma, leiomyomas, hemangiomas and neurofibroma.
Secondary retinal tumors are mostly metastasized from intra-abdominal malignant tumors (such as gastrointestinal, peritoneal, retroperitoneal tissue or malignant tumors of the uterus, ovary, etc.), the most common ones are from malignant tumors of gastric cancer and ovary. Membrane teratoma can be encountered, mostly in the form of cysts.
Prevention
Omental tumor prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
Complication
Omental tumor complications Complications, anemia, ascites
Malignant omental tumors may be associated with systemic wasting, anemia or cachexia, or may have bloody or non-blood ascites.
Symptom
Omental tumor symptoms Common symptoms Abdominal gradual enlargement Abdominal mass Non-blood ascites cachexia Weight loss Abdominal pain Nausea bloating
Secondary tumors are often found during surgical exploration of other organ lesions or at the same time as advanced recurrent tumors. The prominent feature is abdominal swelling. Most patients have abdominal pain and abdominal distension.
1. Abdominal pain: When the tumor is large, most patients have abdominal pain, fullness and dysfunction of the digestive tract. 65% of patients may have abdominal pain, the pain is aggravated when lying on the back, the standing position is relieved, and a few cases have nausea.
2. Abdominal percussion can touch the mass. The primary tumor is characterized by a gradual enlargement of the abdomen. The abdominal mass can be found in the physical examination.
3. Ascites: malignant tumors may have ascites in the late stage, may have bloody or non-blood ascites, and have percussive dullness.
4. Weight loss: Patients with malignant tumors have obvious systemic symptoms and weight loss, which may be accompanied by systemic wasting, anemia or cachexia.
Examine
Omental tumor examination
No specificity, blood routine examination may have anemia, ascites test mostly bloody exudate, should be done histopathological examination.
1. X-ray examination: used to judge the location of the large omental mass. If the abdominal plain film shows a tumor shadow in front of the abdominal cavity or a gastrointestinal barium meal examination, it is found that there is a tumor in front of the intestinal tube and it has nothing to do with the intestinal tube. A tumor of the omentum.
2. B-mode ultrasonography: It has a preliminary judgment on the omental inflammatory mass, cyst or tumor. It helps to determine the location of the tumor, and its nature is cystic or solid.
3. CT examination: CT scan can display a variety of images, masses, massive omentum, small nodular invasiveness, cystic mass or multiple isolated nodules, is the best means to determine the large omentum mass It can not only determine the location of the tumor and its relationship with surrounding tissues and organs, but also has a good diagnostic value for the greater omental torsion and vascular infarction.
4. Laparoscopy: combined with biopsy can determine the cause and nature of the lesion.
Diagnosis
Diagnosis of omental tumor
The diagnosis of retinal tumors is difficult, and most cases are diagnosed because of abdominal masses for exploration or because of tumors found in the omentum during abdominal surgery.
1. Clinical manifestations: abdominal pain aggravated when lying on the back; abdominal mass with weight loss; a lot of ascites can have mobile dullness.
2. Laboratory and auxiliary examination: CT examination can assist in diagnosis.
3. Histopathological examination: The nature and type of the tumor can be determined.
Preoperative correct diagnosis of omental tumors is difficult. The diagnosis should be differentiated from the following conditions: retinitis, retroperitoneal tumor, ovarian cyst, pancreatic cyst, spleen cyst, peritoneal mesothelioma, peritoneal pseudomyxoma.
