An 18-year-old boy had a papaya-sized tumor "hidden" in his abdomen. Doctors defuse the crisis with their skillful hands

Xiaojie, an 18-year-old boy from Changsha, discovered a huge lump in his abdomen during a physical examination. He and his family were really shocked because he had never felt its existence.

Xiaojie is a student who is healthy and has a normal life and study. If it weren't for the physical examination, no one would have thought that a huge tumor had quietly grown in his abdomen. For further treatment, Xiaojie's family took him to the Pediatric Surgery Department of the Children's Medical Center of Hunan Provincial People's Hospital . The examination found that the tumor was located on the right side of the middle abdomen, and there was no pain when touching or pressing it.

▲The huge mass shown in the CT results.

After a multidisciplinary consultation, Yan Dayi, director of pediatric surgery, led a team to remove the tumor for Xiaojie through surgery. During the operation, it was found that the mass was closely connected to the right ureter and wrapped around the ureter, and was closely adhered to the small intestine mesentery. The mass was about 17×12cm and weighed 795g, about the size of a papaya. Postoperative pathology showed aggressive fibromatosis. After recovery after the operation, Xiaojie was discharged from the hospital on March 18.

▲Director Yan Dayi of the Pediatric Surgery Department performed surgery to remove the tumor from Xiaojie.

Director Yan Dayi introduced that aggressive fibroma, also known as desmoid fibromatosis, is a rare borderline tumor that is between benign and malignant. It originates from fibrous connective tissue and is locally invasive but has no metastatic potential.

The incidence of aggressive fibroids is about 2 in a million, and it is more common in young and middle-aged people aged 30-40, with more women than men. It may be related to hormones (such as pregnancy, oral contraceptives). About 10%-15% of cases are related to familial adenomatous polyposis, which is more common in the abdominal wall (especially postpartum women), mesentery, limbs, and shoulders and neck.

Director Yan Dayi reminded that the clinical manifestations of aggressive fibromatosis are related to the location, size, and growth rate of the tumor. It can silently invade connective tissues such as muscles, fascia, and aponeurosis. Although it is classified as benign, its invasive growth characteristics are enough to cause serious damage to surrounding tissues. The early symptoms of abdominal tumors are relatively hidden, so parents are advised to take their children for regular physical examinations and screening to achieve early detection and early treatment.

Hunan Medical Chat Special Author: Yang Juan, Pediatric Surgery, Hunan Provincial People's Hospital

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(Edited by YT)