Sakai Makoto, Kato Hiroyuki, Saito Kana, Tanaka Naritaka, Inose Takanori, Kimura Hitoshi, Miyazaki Tatsuya, Kuwano Hiroyuki
Department of General Surgical Science (Surgery I), Gunma University, Graduate School of Medicine, Gunma, Japan.
Int Surg. 2008 Jul-Aug;93(4):209-13.
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms affecting the gastrointestinal tract. Esophageal GISTs are very rare, but recognition of esophageal GISTs has been increasing recently. We report a patient with an esophageal GIST that showed increased uptake on 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET). In this case, preoperative diagnosis was assumed to be esophageal cancer, but postoperative histopathological and immunohistochemical examination showed it to be a malignant GIST. We also found an activating mutation of kit in this patient; the mutation type was an in-frame deletion of a portion of the juxtamembrane domain (exon11). FDG-PET is useful not only for evaluating the bioactivity but also the malignant potential of esophageal GISTs.
胃肠道间质瘤（GISTs）是影响胃肠道的最常见间叶性肿瘤。食管GISTs非常罕见，但近年来对食管GISTs的认识一直在增加。我们报告一例食管GIST患者，其在18F-氟脱氧葡萄糖（FDG）-正电子发射断层扫描（PET）上显示摄取增加。在该病例中，术前诊断为食管癌，但术后组织病理学和免疫组化检查显示为恶性GIST。我们还在该患者中发现了kit基因的激活突变；突变类型为近膜结构域（外显子11）一部分的框内缺失。FDG-PET不仅有助于评估食管GISTs的生物活性，还能评估其恶性潜能。
