| 摘要 |
Malignant extrarenal rhabdoid tumors (MERT) of the omentum which results in
massive hemoperitoneum is extremely rare. We herein report a case of a 25 year-old
male with a spontaneously ruptured MERT from the omentum presenting with
hemoperitoneum. The patient was brought to our emergency department with an 11-
day history of poor appetite and progressive abdominal distension. An abdominal
computed tomography scan revealed soft tissue infiltration into the omentum and
mesenteric fat of the bowel loop, which caused suspicion of omentum cake
formation, and a hypervascular liver mass with a hypoattenuated center was also
noted. Abdominal angiography showed no active bleeders. After admission,
progressive hemoperitoneum with exacerbated hypovolemia and elevated
intraabdominal pressure were noted. At emergent laparotomy, massive
hemoperitoneum of about 7,000 ml, and an omentum cake with diffuse peritoneal
tumor seeding and oozing from the surface of the tumor were noted. Debulking
resection of the omental tumor was done. Immunohistochemical examination
revealed a tumor positive for cytokeratin and vimentin, but negative for CD31,
CD34, desmin and INI1. The patient had an uneventful postoperative course without
residual tumor bleeding. However, tumor bleeding induced by chemotherapy with
ifosfamide and carboplatin occurred. |
