Carvajal H Carlos, Iturra U Sebastián, Justiniano P Juan Carlos, Bustamante Z Marco, Contreras P Juan Eduardo, Lombardi S Juan, Capetillo Fuentes María
Departamento de Cirugía, Facultad de Medicina, Universidad de Chile (Campus Oriente) Santiago de Chile.
Rev Med Chil. 2006 Apr;134(4):481-4. doi: 10.4067/s0034-98872006000400012. Epub 2006 May 25.
Gastrointestinal stromal tumors (GIST) are lesions whose diagnosis and treatment have varied in the last decade. We report a 76 year-old male with a history of eight episodes of upper gastrointestinal bleeding. A duodenography showed an elevated lesion in the third portion of the duodenum with a central ulceration. It was initially managed with tumorectomy and primary closure of the duodenum. The pathological study of the surgical specimen revealed a low grade gastrointestinal stromal tumor. Three years later, the tumor recurred and pancreatoduodenectomy was performed. Due to the high risk of malignant potential, tumor size, number of mitoses and the presence of necrosis, imatinib mesylate was started. The patient had a satisfactory evolution, without evidences of recurrence after 15 months of follow up.
胃肠道间质瘤(GIST)是一类在过去十年中诊断和治疗方式有所变化的病变。我们报告一例76岁男性,有8次上消化道出血病史。十二指肠造影显示十二指肠第三段有一隆起性病变,中央有溃疡。最初行肿瘤切除术并对十二指肠进行一期缝合。手术标本的病理研究显示为低级别胃肠道间质瘤。三年后,肿瘤复发,遂行胰十二指肠切除术。鉴于恶性潜能高、肿瘤大小、有丝分裂数量及存在坏死,开始使用甲磺酸伊马替尼治疗。患者病情进展良好,随访15个月后无复发迹象。