5 Types of Mesenteric Tumors and Its Treatment in India
Added: (Thu Sep 02 2010)
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1. Benign mesenteric Tumors
Benign mesenteric tumors are almost exclusively found in the mesentery of the small intestine, although cysts of the colonic mesentery have also been described. Most are lymphangiomas, but simple peritoneal cysts and enteric cysts are also found, as well as rare mesenteric mesotheliomas with prominent cystic components. In general, surgical treatment of benign mesenteric tumors consists of local excision for smaller lesions and resection for bulkier tumors, provided the blood supply to the gut is not jeopardized.
2. Malignant mesenteric tumors
A relatively few tumor types comprise the vast majority of mesenteric malignancies; of these, the small bowel mesentery is almost exclusively the site of involvement. Surgical treatment is the only therapy of demonstrated benefit for Malignant mesenteric tumors. The goal of surgical treatment is removal of gross disease with a margin of normal tissue. This requires resection of any involved intestine, as well as of intestine robbed of mesenteric arterial blood supply by the dissection to remove the tumor. As in the treatment of intestinal stromal tumors or retroperitoneal sarcomas, operative management may involve en bloc resection of other involved structures.
3. Mesenteric desmoid tumors
Mesenteric desmoid tumors are a relatively infrequent but potentially life-threatening complication of familial adenomatous polyposis Mesenteric desmoids tumors are very difficult lesions to treat surgically. Surgical treatment may increase recurrence risk, because it has been observed that desmoid tumors generally occur following abdominal surgery. Surgical debulking may be dangerous and ultimately unsuccessful and is generally reserved for patients with intestinal obstruction.
4. Mesenteric lymphoma
In contrast to primary small bowel lymphoma, in which surgical treatment may play a valuable role in selected cases, Mesenteric lymphoma is best treated with combination chemotherapy. Although some cases are diagnosed following resection of an uncharacterized mesenteric mass, surgical treatment is best used as a diagnostic tool when the diagnosis is probable but uncertain. Laparoscopy may play an important role when the procurement of tissue for diagnostic purposes is the operative goal.
5. Mesenteric carcinoid tumor
The treatment of Mesenteric carcinoid tumor pattern of disease is to surgically resect the mesenteric masses. This procedure should be performed en bloc with any extant primary intestinal tumor. Resection of mesenteric disease should be accomplished without endangering the blood supply to normal bowel, except in the immediate area of the disease. A primary carcinoid tumor, which may be quite small and multicentric, is generally found in the resected intestinal specimen.
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