Okada Kazuyuki, Maruyama Kentaro, Nagase Hirotsugu, Matsunaga Hiroki, Ide Yoshihito, Ota Hideo, Murata Kohei, Yokouchi Hideoki, Nakamichi Itsuko, Kinuta Masakatsu
Dept. of Surgery, Suita Municipal Hospital.
Gan To Kagaku Ryoho. 2008 Nov;35(12):2080-2.
A 75-year-old man was admitted to our hospital with massive hematemesis. Upper gastrointestinal endoscopy revealed a submucosal gastric tumor with ulcer lesion, about 30 mm in diameter, in the anterior wall of the cardia. Pathological findings of biopsy specimens showed a gastrointestinal stromal tumor (GIST) of the stomach. Abdominal computed tomography (CT) showed an extramural low density mass, measuring 27 mm, in the cardia. From these findings, we thought we should be performing a wedge resection of the stomach for this tumor. After one month from the first examination, preoperative upper gastrointestinal endoscopy revealed a growth of the tumor. Abdominal CT also showed an obvious growth of the tumor, measuring 50 mm. Thus, laparoscopy-assisted proximal gastrectomy was performed, because the tumor was close to the cardia. Postoperative diagnosis of the tumor was pathologically confirmed to be a GIST with a high malignant potential. The case report of GIST that shows rapid growth for a short term is rare. We herein describe a case of GIST with rapid growth during one month before the operation.
一名75岁男性因大量呕血入院。上消化道内镜检查发现贲门前壁有一个直径约30毫米的带溃疡病变的胃黏膜下肿瘤。活检标本的病理检查结果显示为胃胃肠道间质瘤（GIST）。腹部计算机断层扫描（CT）显示贲门处有一个27毫米的壁外低密度肿块。根据这些发现，我们认为应对该肿瘤进行胃楔形切除术。首次检查一个月后，术前上消化道内镜检查显示肿瘤生长。腹部CT也显示肿瘤明显生长，大小为50毫米。由于肿瘤靠近贲门，因此进行了腹腔镜辅助近端胃切除术。术后肿瘤的诊断经病理证实为具有高恶性潜能的GIST。短期内显示快速生长的GIST病例报告很少见。我们在此描述一例术前一个月内快速生长的GIST病例。
