primary mesenteric tumor
Introduction
Introduction to primary mesenteric tumors Primary mesenteric tumors (primarymesenteric tumor) are rare and cystic. The ratio of cystic and solid tumors is 2:1. The cysticity is mostly benign. The rare exception is lymphangiosarcoma and malignant teratoma. Solid tumors are difficult to distinguish between benign and malignant before surgery. basic knowledge The proportion of illness: 0.02% - 0.07% Susceptible people: no special people Mode of infection: non-infectious Complications: fibromatosis
Cause
Cause of primary mesenteric tumor
(1) Causes of the disease
Primary mesenteric solid tumors can originate from any cellular component of the mesentery, such as epithelial cells derived from the mesentery - mesenteric mesothelioma; lymphatic-mesenteric lymphoma; fibroblast-demonoma.
(two) pathogenesis
1. Germ cell-derived tumors.
Cysts and other benign tumors (41%):
(1) cyst: serous cyst, cystic lymphangioma, cavernous lymphangioma, chyle cyst, hemorrhagic cyst, dermoid cyst. (2) benign tumors: leiomyomas, benign vascular endothelioma and angioendothelioma, neurofibromatosis, lipoma, fibroids or fibromatosis, teratoma, foreign body giant cell granuloma.
The above-mentioned various types of tumors are more common in serous cysts, fibroids, and leiomyomas. They can occur at any age. The difference between men and women is small. The cysts can be as large as 10 to 20 cm without clinical symptoms, but multiple atrial cysts. The inside is lymph, if it contains chyle, it is called chylorrhea cyst, and the bleeding is called blood cyst.
Primary malignancy (27%):
Mesenteric malignant tumors include leiomyosarcoma, rhabdomyosarcoma, fibrosarcoma, liposarcoma, malignant hemangiopericoma, yellow granuloma, reticulum sarcoma, lymphosarcoma, Hodgkin's disease, carcinoid, adenocarcinoma, neuroma malignant, malignant lipid Liquid tumor, mesothelioma.
Prevention
Primary mesenteric tumor prevention
1. Regular examination: high-risk groups of primary mesenteric tumors, such as men over 40 years old, familial multiple intestinal polyps, ulcerative colitis, chronic schistosomiasis and family history of colorectal cancer should be checked regularly .
2, improve eating habits: change the habit of eating meat and high protein foods. Eat less fatty foods, especially to control the intake of animal fat. Reasonably arrange daily diet, eat more fresh fruits, vegetables and other foods rich in carbohydrates and crude fiber, increase the proportion of coarse grains and miscellaneous grains in staple foods, and should not be too fine.
3, prevention and treatment of intestinal diseases: active prevention of various polyps, chronic enteritis (including ulcerative colitis), schistosomiasis, chronic dysentery, etc., for intestinal polyps should be treated earlier. Colorectal polyps are divided into five categories, namely, adenomatous polyps, inflammatory polyps, hamartomatous polyps, biochemical polyps and mucosal hypertrophy, among which adenomatous polyps are true neoplastic polyps. In addition, you should actively treat habitual constipation, pay attention to keep the stool smooth.
Complication
Primary mesenteric tumor complications Complications fibromatosis
If the benign tumor can be completely resected, if there is not complete resection or incomplete resection, some tumors such as lipoma, fibroids, leiomyoma, etc. may have recurrence. If it is a malignant tumor, metastasis may occur.
Symptom
Symptoms of primary mesenteric tumors Common symptoms Intussusception abdominal pain Abdominal mass Ascites tumor block oppression sickness Dull pain Intestinal tube deformation
Primary mesenteric tumor is difficult to diagnose before operation. The final diagnosis depends on surgery and pathology. The clinical manifestations are also different due to tumor size, nature and growth rate. There are no clinical symptoms of benign tumors. The mass compresses the symptoms of adjacent organs.
1. Abdominal masses are mostly painless masses, which are inadvertently touched by the patient. If the patient does not pay much attention to the treatment, the patient will grow up and wait for the tumor to grow up. Then the symptoms are gradually found to account for 77.86%.
2. Abdominal pain Sustained dull or dull pain, more common in malignant tumors, accounting for 66.7%.
3. Weight loss Anemia is more common in malignant tumors.
4. Ascites, cachexia is more common in advanced malignant cases.
5. Intestinal obstruction Hu Desheng (1982) reported 21 cases of intestinal obstruction caused by primary mesenteric tumor, accounting for 30% of the primary lesions in the same period, both large and small intestines, benign and malignant may have intestinal obstruction, 5 cases of intestinal torsion, intestine There were 4 cases of intussusception, 4 cases of intestinal wall compression, and 3 cases of intestinal wall infiltration.
6. Physical examination Abdominal can touch the mass, benign tumors are mostly round, movable mass, clear boundary, no tenderness; malignant can touch the activity or fixed mass, more uneven, hard.
Examine
Examination of primary mesenteric tumors
1. X-ray gastrointestinal barium meal angiography can show that the intestinal tube has compression deformation, stenosis, displacement.
2. B-ultrasound and CT examination B-ultrasound and CT examination can be distinguished in the retroperitoneal or intra-abdominal cavity, cyst, cystic solid, solid tumor, and can see the size of the mass, the boundary situation, cystic can be seen in the capsule Separate.
Diagnosis
Diagnosis and diagnosis of primary mesenteric tumor
Firstly, it is determined that the retroperitoneal tumor or mesenteric tumor is confirmed to be benign or malignant. It is also excluded whether it is mesenteric abscess, abscess has fever, cystic mass, and separation is found during imaging examination. Generally, the retroperitoneal tumor is more fixed. Abdominal tumors can often move left and right or up and down, and develop slowly, polycystic, smooth, clear boundaries, good general condition, rapid development of malignant tumors, rapid growth, systemic symptoms, fever, weight loss with abdominal pain, anemia, late There are ascites, the mass is hard, uneven or fixed, and more solid.
Mesenteric fibroma should be differentiated from metastatic adenocarcinoma, especially those with familial polyps.
