Rubbia-Brandt Laura, Huber Olivier, Hadengue Antoine, Frossard Jean Louis
Division of Clinical Pathology, Clinic of Digestive Surgery, Geneva University Hospitals, Geneva, Switzerland.
JOP. 2004 Nov 10;5(6):484-7.
Submucosal lesions of the gastrointestinal tract represent a diagnostic challenge for the physician. Endoscopic ultrasonography may provide useful information before deciding on therapeutic strategy.
We report on a case of a young female presenting with a large gastric submucosal mass, 32 mm in size. Endoscopic ultrasonography identified a non-homogeneous lesion, with three cystic spaces suggesting a degenerated gastrointestinal stromal tumor. An exploratory laparoscopy was performed. Surprisingly, the final diagnosis was gastric heterotopic pancreas.
Heterotopic pancreas should always be kept in mind when facing extramucosal gastric masses, especially in young people. A perioperative biopsy is recommended to prevent unnecessary extensive surgery.
胃肠道黏膜下病变对医生来说是一项诊断挑战。内镜超声检查在决定治疗策略之前可能会提供有用信息。
我们报告一例年轻女性病例，其胃内有一个大小为32毫米的巨大黏膜下肿块。内镜超声检查发现一个不均匀病变，有三个囊性腔隙，提示为退变的胃肠道间质瘤。进行了探查性腹腔镜检查。令人惊讶的是，最终诊断为胃异位胰腺。
面对胃黏膜外肿块时，尤其是年轻人，应始终考虑到异位胰腺。建议进行围手术期活检以避免不必要的广泛手术。
