No abstract

Solitary fibrous tumor (SFT) is an uncommon neoplasm located in the pelvis. Here, we report a case of hypervascular malignant SFT in the mesentery of the rectum that showed a significant response to preoperative radiotherapy. A 36-year-old man presented to our department with constipation and dysuria. Abdominal computed tomography confirmed a large round neoformation (155 mm in the longest diameter) with an evident contrastenhanced periphery and a central necrotic area in the pelvis. Considering the results of the examinations, a pelvic neoplasm was strongly suspected. Due to the difficulty of safe gross total removal, a diagnostic laparotomy was indicated. Histologically, hypercellularity with spindleshaped cells and high mitotic activity was observed. Immunohistochemically, the tumor was positive for CD34, CD99, and bcl-2. The diagnosis of hypervascular malignant SFT was made. After the appropriate information had been given, the patient chose the use of preoperative radiotherapy. After local irradiation, the tumor size regressed to 105 mm in the longest diameter. Laparotomy revealed a tumor originating from the mesentery of the rectum, and the tumor was successfully excised. This case strongly suggested the potential applicability of preoperative radiotherapy for the safe gross total removal of a large pelvic SFT.

Perforation of Meckel's diverticulum with enteroliths is a rare complication. Here, we report a case of perforation of Meckel's diverticulum with enteroliths, which could be accurately diagnosed by the preoperative computed tomography (CT). A 46-year-old man with acute onset of severe abdominal pain, and a localized muscle guarding in the right hypochondrium, had a solitary stone detected in the right abdomen by the radiography. The abdominal CT revealed a saclike outpouching of the small intestine, containing air/fluid levels and an enterolith, with surrounding free air and mesenteric inflammatory change in the right paraumbilical area. He was diagnosed as the perforation of Meckel's diverticulum with enterolith, and the emergency operation was indicated. The perforated Meckel's diverticulum was identified approximately 90 cm proximal to the ileocecal valve. The diverticulum was transected at the base, and removed. The patient's postoperative course was uneventful. This case strongly suggested the ability of CT enterography to accurately diagnose pathologies involving the small intestine, such as the perforation of Meckel's diverticulum, which open premises for its use in the diagnosis of acute abdomen preoperatively.

Serous borderline tumors (SBTs) are nonaggressive and have excellent prognosis. Furthermore, SBTs with micropapillary pattern (SBT-MP) are known to be associated with a higher recurrence rate, microinvasions and invasive implants compared to typical SBTs, and these characteristics have adverse effects on prognosis. Here, we report a case of SBT with micropapillary pattern (SBT-MP) that developed 6 recurrences over 30 years after primary surgery. The patient was a 70 year-old woman. At 41 years of the age she underwent total abdominal hysterectomy, bilateral salpingo-oophorectomy, partial omentectomy and pelvic lymphadenectomy and was found to have an SBT-MP involving the right ovary (International Federation of Gynecology and Obstetrics 2014, stage IC2). She was administered chemotherapy (cyclophosphamide, adriamicin, and cisplatin). She repeatedly developed recurrences 6 times after primary surgery. A left inguinal recurrence at age 55, a right inguinal recurrence at age 56, a right inguinal recurrence at age 64, an umbilical recurrence at age 65, a right inguinal recurrence at age 68 and left axillary recurrence at age 70. Histopathological examinations revealed that all recurrences were SBT-MP with noninvasive implants. Our case strongly justifies the belief that recurrent SBTs carry an excellent prognosis unless they develop significant malignant transformation.