A Case of Perivascular Epithelioid Cell Tumor（PEComa）with Peritoneal Recurrence

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 75; no. 5; pp. 1423 - 1427
• Main Authors: TAKAHASHI, Hideyuki, KANEDA, Kunihiko, SAKAI, Tetsuya, HARADA, Naoki, HORII, Shinichi, OKAMURA, Akiharu, HASE, Mamoru
• Format: Journal Article
• Language: Japanese
• Published: Japan Surgical Association 2014
• Subjects: peritoneal recurrence; perivascular epithelioid cell tumor; PET–CT
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.75.1423

The patient was a 68-year-old man who underwent a removal of a huge tumor with the size of 90 × 140 × 100mm occupying the pelvic cavity in December 2012. Histopathologically it was perivascular epithelioid cell tumor (PEComa), and the tumor was found to have adhered to the sigmoid colon. Associated resection of a part of the sigmoid colon was performed as well. Since the bowel mucosa surface was normal, the tumor was pathologically considered to have arisen in the mesentery of the sigmoid colon. The mitotic figure was less than 1/10 HPP, but the tumor diameter was more than 5 cm and the center part of the tumor extensively necrotized. Accordingly a possibility of a tumor with malignant potential could not be ruled out and thereafter the patient had periodically been followed in the clinic. A follow-up abdominal CT performed in October 2013 after a one-year interval revealed an about 55-mm diameter tumor in the lower abdomen. FDG-PET showed an abnormal uptake of FDG (SUVmax of 5.828) at the right anterior part of the pelvic cavity where was coincided with the location of the tumor. From these findings, peritoneal recurrence of PEComa was likely. The tumor was thus removed. The same pathological findings as the primary lesion showed were reported. The postoperative course was uneventful. The patient was discharged from the hospital on the 7th postoperative day. There is a risk of re-recurrence of PEComa, so that further abdominal PET-CT scans are scheduled every 3-4 months.