Kimura Masaki, Irie Akira, Minei Sadatsugu, Ishii Junichiro, Okawa Asako, Takashima Rikiya, Kadowaki Kazuomi, Morinaga Shojiro, Baba Shiro
Department of Urology, The Kitasato Institute Hospital.
Hinyokika Kiyo. 2007 Aug;53(8):551-5.
A 48-year-old man was referred to our institute for the evaluation of a concomitant gastric submucosal tumor and right adrenal tumor, incidentally found by ultrasound examination. Computed tomography showed a mass with a diameter of 6 cm adjacent to the stomach and the right adrenal tumor with a diameter of 3 cm. These tumors had similar characteristics in both plain and enhanced imagings. By magnetic resonance imaging, the intensity of the right adrenal tumor was equivalent to the liver in both T1 and T2 weighted images. On the other hand, the gastric submucosal tumor showed low intensity in T1 weighted images and high intensity in T2 weighted images. An adosterol scintigram showed slight accumulation at the region of adrenal tumor. The results of all conducted serum and urinary hormonal examinations were found to be within the normal range. Adrenalectomy and partial gastrectomy were performed laparoscopically. Pathological diagnosis of the adrenal tumor was a cortical adenoma, and that of the gastric submucosal tumor was gastrointestinal stromal tumor (GIST). The gastric tumor was immunohistochemically stained positive with the C-kit and CD34 and negative for s-100 protein and desmin. Histopathological diagnosis was coincident with gastric GIST and right adrenocortical adenoma, and the GIST was diagnosed as a high risk tumor because its diameter was over 5 cm.
一名48岁男性因超声检查偶然发现同时患有胃黏膜下肿瘤和右肾上腺肿瘤而被转诊至我院。计算机断层扫描显示，胃旁有一个直径6厘米的肿块，右肾上腺肿瘤直径3厘米。在平扫和增强成像中，这些肿瘤具有相似的特征。通过磁共振成像，右肾上腺肿瘤在T1加权像和T2加权像上的信号强度与肝脏相当。另一方面，胃黏膜下肿瘤在T1加权像上呈低信号，在T2加权像上呈高信号。肾上腺闪烁扫描显示肾上腺肿瘤区域有轻微放射性聚集。所有血清和尿液激素检查结果均在正常范围内。通过腹腔镜进行了肾上腺切除术和胃部分切除术。肾上腺肿瘤的病理诊断为皮质腺瘤，胃黏膜下肿瘤的病理诊断为胃肠道间质瘤（GIST）。胃肿瘤免疫组化染色C-kit和CD34呈阳性，s-100蛋白和结蛋白呈阴性。组织病理学诊断与胃GIST和右肾上腺皮质腺瘤相符，该GIST因其直径超过5厘米而被诊断为高危肿瘤。
