title: Successful low-dose chemotherapy using vinblastine and methotrexate for the treatment of an ileoanal pouch mesenteric desmoid tumor: report of a case.
abstract: The purpose of this report was to describe the first known case of ileoanal pouch salvage by a low-dose regimen of vinblastine and methotrexate chemotherapy for the treatment of desmoid tumor arising from the mesentery of the ileoanal pouch in a patient who had undergone ileal pouch-anal anastomosis for familial adenomatous polyposis. Mesenteric desmoid tumor involving the ileoanal pouch in a 28-year-old female was treated with vinblastine and methotrexate biweekly for 12 months and monthly for 12 months in an outpatient unit. The desmoid tumor response to the treatment was assessed at routine intervals by physical examination and magnetic resonance imaging. Desmoid tumor was successfully treated with a low-dose regimen of vinblastine and methotrexate chemotherapy without significant side effects, and function of the ileoanal pouch was fully preserved. Magnetic resonance imaging showed a decrease in desmoid tumor size and cellularity, and changes consistent with fibrosis. This is a unique case highlighting the possibility of ileoanal pouch salvage by low-dose combination chemotherapy using vinblastine and methotrexate in a familial adenomatous polyposis patient with mesenteric desmoid tumor.
authors.affiliation: Second Department of Surgery, Asahikawa Medical College, Asahikawa, Hokkaido, Japan. kono@asahikawa-med.ac.jp
authors.forename: Toru
authors.initials: T
authors.lastname: Kono
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tomita
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Chisato
authors.forename: Minoru
authors.initials: M
authors.lastname: Matsuda
authors.forename: Akitoshi
authors.initials: A
authors.lastname: Kakisaka
authors.forename: Shinichi
authors.initials: S
authors.lastname: Kasai
mesh_terms: D011125:Adenomatous Polyposis Coli / Q000601:surgery; D000328:Adult; D001003:Anal Canal / Q000601:surgery; D000714:Anastomosis, Surgical; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D039021:Colonic Pouches / Q000473:pathology*; D005260:Female; D018222:Desmoid Tumors / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008643:Mesentery / Q000473:pathology*; D008727:Methotrexate / Q000008:administration & dosage; D010534:Peritoneal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D014747:Vinblastine / Q000008:administration & dosage
chemical_list: D014747:Vinblastine; D008727:Methotrexate