Kinkor Z, Daum O
Bioptická laborator s.r.o., Plzeń.
Ceska Gynekol. 2008 Jan;73(1):54-7.
The aim of this study is to address difficulties in diagnosis of the extraintestinal gastrointestinal stromal tumor (GIST) when even in ovary is the tumor. One should ever think of the GIST in the case of peritoneal dissemination of the spindle/epithelioid cell tumor. In contrary, the late intraabdominal recurrence of primary both epithelial and non-epithelial tumor of genital tract can be undistinguishable by pure morphology. Complete clinical records and accurate operation field topography are both of great value. Documenting this phenomenon, presented is both late intraabdominal dissemination of primary uterine endometrial stromal sarcoma and massive ovarian involvement by extraintestinal GIST.
Two case reports.
Biopsy Lab s.r.o. and Sikl's Department of Pathology, Charles University and Faculty Hospital, Pilsen.
The two casuistic reports are covered in detail including broad immunohistochemistry (LSAB+, Dako) and genetics (ABI Prism 310, PE/Applied Biosystems).
In 75-year-old woman, 5 cm tumor in maximum diameter of the mesentery was diagnosed as an extraintestinal GIST. Multiple peritoneal recurrence occurred ten years later and the tumor has been reclassified as a disseminated endometroid stromal sarcoma. Ultimately, comprehensive search of clinical files confirmed hysterectomy and adnexotomy in 1973. The second case describes 49-year-old woman operated for tumorous obliteration of the small pelvis where a tumor 9 cm in maximum diameter was found. Initially, predominant epitheloid morphology of the tumor led to the diagnosis of primary epithelial malignancy, sex-cord stromal tumor or metastatic melanoma of the ovary. Finally, the help of immunohistochemistry and molecular biology rendered the tumor as an extraintestinal GIST, ovarian primary not excluded.
本研究旨在解决当胃肠道间质瘤（GIST）发生在卵巢时的诊断难题。对于梭形/上皮样细胞瘤出现腹膜播散的情况，应考虑到GIST。相反，生殖道原发性上皮性和非上皮性肿瘤的晚期腹腔内复发，单纯通过形态学难以区分。完整的临床记录和准确的手术野地形图都具有重要价值。为记录这一现象，现展示原发性子宫内膜间质肉瘤的晚期腹腔内播散以及胃肠道外GIST对卵巢的广泛累及。
两例病例报告。
Biopsy Lab s.r.o.以及查尔斯大学和皮尔森市医学院附属医院的西克尔病理科。
详细报道这两例病例，包括广泛的免疫组织化学（LSAB +，达科公司）和遗传学检测（ABI Prism 310，PE/应用生物系统公司）。
一名75岁女性，肠系膜上最大直径为5 cm的肿瘤最初被诊断为胃肠道外GIST。十年后出现多处腹膜复发，肿瘤被重新分类为播散性子宫内膜样间质肉瘤。最终，全面查阅临床档案证实1973年进行了子宫切除术和附件切除术。第二例描述的是一名49岁女性，因盆腔肿瘤性闭塞接受手术，发现一个最大直径为9 cm的肿瘤。最初，肿瘤以主要的上皮样形态导致诊断为原发性上皮恶性肿瘤、性索间质肿瘤或卵巢转移性黑色素瘤。最后，免疫组织化学和分子生物学检测结果表明该肿瘤为胃肠道外GIST，不排除卵巢原发性。
