Marin I, Doran H, Catrina E, Degeratu D, Predescu G, Zaharia R, Pătraşcu T
Clinica de chirurgie "Prof. I. Juvara", Spitalul Clinic "Dr. I. Cantacuzino", Bucuresţi.
Chirurgia (Bucur). 2009 Mar-Apr;104(2):213-7.
The gastric plasmacytoma represents a rarely encountered, so that, the diagnosis criteria, the medical attitude and the evolution of this disease are less coded. It is known the fact that this tumours, extramedullary plasmacytomas with gastric localization, develop in soft submucous tissue, therefore it's very difficult or even impossible preoperative diagnosis through an upper endoscopy including biopsy. We present the case of a 54 years old patient, with no significant pathological personal record, that was admitted in our Clinic for having melenic dark stools which have repeated within a 6 months period prior to this hospitalisation. Repeated gastric mucosal samples taken in another medical unit shown normal aspects, contrary to all imaging testing (e.g. ultrasonography, upper endoscopy and barium swallow) which revealed a tumor mass of considerable extent at the level of the gastric corpus. First-line therapy was gastric resection followed by radiotherapy, because it is well known that the tumour is highly radiosensitive. The patient's postoperative course was satisfactory, showing no signs or recurrence 6 months after surgery at upper endoscopy and CT-scan.
胃浆细胞瘤是一种罕见的疾病,因此,这种疾病的诊断标准、医学处理方式及病情发展情况都缺乏明确规范。众所周知,这种肿瘤即胃局限性的髓外浆细胞瘤,发生于柔软的黏膜下组织,因此通过包括活检在内的上消化道内镜检查进行术前诊断非常困难甚至不可能。我们报告一例54岁患者,既往无明显病理病史,因在本次住院前6个月内反复出现黑便而入住我院。在另一家医疗单位采集的多次胃黏膜样本显示正常,但所有影像学检查(如超声、上消化道内镜和吞钡检查)均显示胃体部有相当大的肿瘤肿块。一线治疗为胃切除术后放疗,因为众所周知该肿瘤对放疗高度敏感。患者术后恢复良好,术后6个月上消化道内镜检查和CT扫描均未显示复发迹象。