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Totally extraperitoneal resection of a solitary fibrous tumor

Danny Sherwinter, MD. Maimonides Medical Center

Background: Abdomino-pelvic solitary fibrous tumor (AP-SFT) is a rare entity traditionally managed by open surgery and wide resection. We present a case of a young patient with AP-SFT resected endoscopically employing a totally extra-peritoneal approach.

Methods: This is a 48-year-old male found to have a 4.8cm mass within the right iliacus muscle on imaging performed for vague musculoskeletal complaints. Pelvic, preperitoneal access, was achieved with a balloon then insufflated with CO2. Using a standard 3 trocar technique the lesion was separated from the surrounding muscle and extracted using an extraction bag.

Results: Final pathology confirmed a well encapsulated AP-SFT without mitotic activity, cellular atypia or necrosis. The patient did well postoperatively and was discharged home on post-op day 0. At 1 month follow-up his symptoms had resolved and he had returned to his full activities.

Conclusion: With increasing experience with extra-peritoneal procedures such as herniorrhaphy (TEP) and transversus abdominus release (TAR), the preperitoneal space is becoming recognized as an excellent access point for a growing number of varied and complex endoscopic procedures.

To our knowledge this is the only report to date of a totally extra-peritoneal resection of this rare lesion.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 78625

Program Number: V050

Presentation Session: Thursday Exhibit Hall Video Presentations Session 3 (Non CME)

Presentation Type: EHVideo

32

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