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Recurrent aggressive mesenteric desmoid tumor successfully treated with sorafenib: A case report and literature review

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World Journal of Clinical Oncology 2019年第4期10卷 183-191页

作者： Aikaterini Mastoraki Dimitrios Schizas Chrysovalantis Vergadis Leon Naar Alexios Strimpakos michail g vailas Natasha Hasemaki george Agrogiannis Theodore Liakakos Nikolaos Arkadopoulos 4th Department of Surgery National and Kapodistrian University of Athens Attikon University Hospital 1st Department ofSurgery National and Kapodistrian University of Athens Laikon Hospital Department of Radiology National and Kapodistrian University of Athens Laikon Hospital 1st Department of Pathology National and Kapodistrian University of Athens

BACKgROUND Desmoid tumors(DT) are locally advanced but histologically benign monoclonal neoplasms that can occur from any musculoaponeurotic structure. The aim of this report is to analyze a rare clinical case of an aggressive intra-abdominal DT successfully treated with *** SUMMARY A 36-year-old man presented with increasing colicky abdominal pain and a selfpalpable mass in his left abdomen. Fourteen years earlier he was diagnosed with a large intra-abdominal tumor, which adhered to the left colonic flexure, part of the major gastric curvature and the spleen. Subsequent exploratory laparotomy revealed a voluminous mass in the epigastrium, arising from the posterior surface of the stomach and invading the superior mesenteric vessels, transverse mesocolon and the small bowel mesentery. As the tumor was unresectable, a jejunojejunal bypass was performed. Traditional therapeutic interventions proved insufficient, and the patient was started on sorafenib with a subsequent fulldisease ***'s pathogenesis has been associated with mutations in the adenomatous polyposis coli(APC) gene or beta-catenin gene CTNNB1, sex steroids or previous surgical trauma. Local treatment modalities, such as surgery or radiotherapy, are implemented in aggressively progressing or symptomatic patients. Sorafenib is a hopeful therapeutic option against DTs, while several pharmacological agents have been successfully used.

关键词： Desmoid tumor Aggressive fibromatosis Case report Pathogenesis Therapeutic approach Sorafenib treatment

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Mechanistic insights of rapid liver regeneration after associating liver partition and portal vein ligation for stage hepatectomy

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World Journal of gastroenterology 2016年第33期22卷 7613-7624页

作者： Demetrios Moris Spyridon Vernadakis Alexandros Papalampros michail vailas Nikolaos Dimitrokallis Athanasios Petrou Dimitrios Dimitroulis Department of Immunology Lerner Research InstituteCleveland Clinic Foundation Laikon general hospital National and Kapodistrian University of Athens

AIM To highlight the potential mechanisms of regeneration in the Associating Liver Partition and Portal vein ligation for Stage hepatectomy models(clinical and experimental) that could unlock the myth behind the extraordinary capability of the liver for regeneration,which would help in designing new therapeutic options for the regenerative drive in difficult setup,such as chronic liver diseases. Associating Liver Partition and Portal vein ligation for Stage hepatectomy has been recently advocated to induce rapid future liver remnant hypertrophy that significantly shortens the time for the second stage hepatectomy. The introduction of Associating Liver Partition and Portal vein ligation for Stage hepatectomy in the surgical armamentarium of therapeutic tools for liver surgeons represented a real breakthrough in the history of liver surgery. METHODS A comprehensive literature review of Associating Liver Partition and Portal vein ligation for Stage hepatectomy and its utility in liver regeneration is performed. RESULTS Liver regeneration after Associating Liver Partition and Portal vein ligation for Stage hepatectomy is a combination of portal flow changes and parenchymal transection that generate a systematic response inducing hepatocyte proliferation and remodeling. CONCLUSION Associating Liver Partition and Portal vein ligation for Stage hepatectomy represents a real breakthrough in the history of liver surgery because it offers rapid liver regeneration potential that facilitate resection of liver tumors that were previously though unresectable. The jury is still out though in terms of safety,efficacy and oncological outcomes. As far as Associating Liver Partition and Portal vein ligation for Stage hepatectomy-induced liver regeneration is concerned,further research on the field should focus on the role of nonparenchymal cells in liver regeneration as well as on the effect of Associating Liver Partition and Portal vein ligation for Stage hepatectomy in liver regener

关键词： Liver regeneration Associating liver partition with portal vein ligation for staged hepatectomy Portal vein embolization Portal vein ligation Liver transection

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