BACKGROUND Peutz-Jeghers(PJ)syndrome(PJS)is a rare autosomal dominant genetic disease characterized by the association of intestinal polyposis,mucosal skin pigmen-tation,and cancer susceptibility.PJS patients have a significantly increased risk of malignant tumors in the gastrointestinal tract and extra-gastrointestinal tract,including various epithelial malignant tumors(colorectal cancer,gastric cancer,pancreatic cancer,breast cancer,and ovarian cancer,etc.).PJS is commonly seen in children and adolescents with multiple small intestinal polyps,often causing intussusception.CASE SUMMARY A 62-year-old male presented with intermittent left lower abdominal pain after drinking or consuming cold beverages that was accompanied by occasional hematochezia.Abdominal contrast-enhanced computed tomography indicated an isolated sigmoid colon grape-like lesion.Subsequently,the patient underwent la-paroscopic surgery,and the pathological diagnosis was PJ hamartomatous polyp.PJS was not considered at the initial visit,as the patient was older,and the facial pigmentation was not obvious.However,significant pigmentation was observed in the perineum during digital rectal examination.Interestingly,we observed that the patient exhibited nodular shadows in the adrenal glands computed tomo-graphy images that may be related to pigmentation.Therefore,we performed the determination of adrenal cortical hormones,but the results were not abnormal.Combined with skin and mucosal pigmentation and laboratory examinations,the patient was diagnosed with PJS.After laparoscopic sigmoid colon resection,the patient's symptoms improved,and no discomfort symptoms were reported in the later follow-up.CONCLUSION The age of onset and lesion location of this case are different from those of typical or isolated PJS patients.
BACKGROUND Aggressive fibromatosis(AF),also known as desmoid tumor or desmoid-type fibromatosis,is a rare soft tissue neoplasm that can occur in almost any part of the body.Although it is a benign disease,AF is aggressive and infiltrative and has a high recurrence rate after surgery.Common sites for intra-abdominal AF are the small bowel mesentery,retroperitoneum,and pelvis.AF in the colon is extremely rare.CASE SUMMARY Here,we report the first case of sigmoid colon AF,which was accidentally discovered in a 27-year-old woman during laparoscopic myomectomy.Computed tomography confirmed a slightly enhanced mass in the sigmoid colon.Subsequent colonoscopy did not reveal a mass in the colonic lumen,but a suspected external compress was found in the sigmoid colon.Surgical disease involving a gastrointestinal stromal tumor was suspected.The patient underwent laparoscopic exploration,and sigmoidectomy with a negative margin was performed to excise the mass.Postoperative immunohistochemistry revealed that the mass was an AF.The patient recovered well and was recurrence-free at the 30-month follow-up without adjuvant therapy.CONCLUSION AF should be considered in the differential diagnosis of subepithelial colon masses.Radical resection alone can achieve good outcomes.
