A HUGE SYNOVIAL SARCOMA OF THE ABDOMINAL WALL COMPLICATED BY ABDOMINAL COMPARTMENT SYNDROME

  • MISE Yoshihiro
    Departments of Surgery, Ibaraki Prefectural Central Hospital
  • YOSHIMI Fuyo
    Departments of Surgery, Ibaraki Prefectural Central Hospital
  • ARAKI Masahiro
    Departments of Internal Medicine, Ibaraki Prefectural Central Hospital
  • IMURA Joji
    Departments of Pathology, Ibaraki Prefectural Central Hospital
  • ASATO Yuji
    Departments of Surgery, Ibaraki Prefectural Central Hospital
  • OKAMOTO Kojun
    Departments of Surgery, Ibaraki Prefectural Central Hospital

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Other Title
  • 急速な増大によりabdominal compartment syndromeを呈した腹壁原発滑膜肉腫の1例

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Abstract

Synovial sarcomas commonly arise in the vicinity of large joints, and grow gradually. In this report, we share our experience in managing a critically ill patient with abdominal compartment syndrome resulting from a rapid growth of a huge synovial sarcoma of the abdominal wall which is quite rare.<br> A 36-year-old man complaining of a lower abdominal mass was admitted to another hospital in December 2004. CT scan showed a huge abdominal mass and nodules in the bilateral lung fields. He was transferred to our hospital for close investigation, but we could not obtain the definite diagnosis with two biopsies. A rapid growth of the mass increased intra-abdominal pressure, causing renal, respiratory and hepatic dysfunction. Conservative therapy did not relieve his symptoms, and we finally performed surgical removal of the tumor, measuring 40×30cm, in January 2005. The pathological diagnosis was biphasic synovial sarcoma arising in the abdominal wall. The patient recovered from multiple organ failure dramatically, and he was discharged from the hospital on postoperative day 17. He is now able to resume his daily life, while receiving adjuvant chemotherapy for the residual tumor.

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