Laparoscopic treatment of a solitary fibrous tumor of the greater omentum presenting as spontaneous haemoperitoneum

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Alberto Patriti, Fabio Rondelli, Nino Gullà, Annibale Donini

Ann. Ital. Chir., 2006; 77: 351-353

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A 24-year-old man was admitted at the emergency department with a lower quadrant abdominal pain and a slight
hypoglycaemia. Abdominal ultrasonography showed the presence of a fluid peritoneal collection and a 3.2 x 2.5 cm hypoisoechogenic
mass closed to the left iliac vessels with an echo-color-Doppler pattern similar to that of a hamartoma. CT
examination confirmed the hypothesis of a vascular tumour. Although an abdominal angiography added no new information
to establish a preoperative diagnosis, it showed a well vascularized mass. The patient underwent laparoscopy that
revealed a bleeding mass of the great omentum. Laparoscopic stapled resection of the greater omentum was carried out.
The solid lesion consisted of spindle-shaped cells, but no atypical cells were observed. The histological findings were diagnostic
of a benign solitary fibrous tumor, an extremely rare neoplasm for a long time considered to be an exclusively
thoracic lesion.
This is the first case of a solitary fibrous tumor presenting as haemoperitoneum and the first time it was removed laparoscopically.
The patient is disease-free at the 2-year follow-up.