病例报告：原发于十二指肠并侵犯结肠的罕见侵袭性纤维瘤病

Case Report: A Rare Desmoid Tumor Primary to the Duodenum with Colonic Invasion

摘要: 侵袭性纤维瘤病(Aggressive Fibromatosis, AF)是一种临床罕见、病因不明的间叶组织来源的交界性肿瘤。由于发病率低且影像学表现缺乏特异性，术前诊断极具挑战性，尤其是腹内型侵袭性纤维瘤病误诊率较高。本文报告一例罕见的腹内型侵袭性纤维瘤病，肿瘤原发于十二指肠降段与水平段交界区，并侵犯升结肠上段、横结肠肝区及肠系膜根部，因腹腔镜下无法实现根治性切除，遂中转开腹，完成了包括根治性十二指肠切除术在内的多脏器联合切除术。通过分析其影像学与病理学特征，并结合文献复习，旨在加深对此病的认识，为临床及影像诊断，以及治疗决策提供参考。

Abstract: Aggressive fibromatosis (AF) is a clinically rare, borderline tumor of mesenchymal origin with an unclear etiology. Due to its low incidence and nonspecific imaging features, preoperative diagnosis is highly challenging, particularly for the intra-abdominal form, which has a high rate of misdiagnosis. This article reports a rare case of intra-abdominal aggressive fibromatosis originating from the junction of the descending and horizontal parts of the duodenum, with invasion into the proximal ascending colon, the hepatic flexure of the transverse colon, and the root of the mesentery. As radical resection was not feasible laparoscopically, the procedure was converted to open surgery, culminating in a multi-organ combined resection that included radical duodenectomy. By analyzing its imaging and pathological characteristics alongside a review of the literature, this report aims to enhance the understanding of this disease and provide references for its clinical and imaging diagnosis, as well as therapeutic decision-making.