Takeuchi Hideya, Matsumoto Toshihumi, Kusumoto Tetsuya, Yoshikawa Yasuji, Muto Yoichi
Department of Surgery, National Hospital Organization Beppu Medical Center, Beppu, Japan.
Case Rep Gastroenterol. 2009 Nov 20;3(3):343-349. doi: 10.1159/000255019.
A case of duodenal gastrointestinal stromal tumor (GIST) treated by wedge resection in a patient with neurofibromatosis type 1 (NF-1) is reported. A 55-year-old man with a history of NF-1 was admitted for surgery for a duodenal tumor. Upper gastrointestinal endoscopy revealed a 2.5 cm duodenal submucosal tumor. Abdominal computed tomography showed a homogenously enhanced mass in the third portion of the duodenum. The patient successfully underwent wedge resection of the duodenal tumor. Histological examination revealed proliferation of spindle tumor cells arranged in a bundle pattern. This tumor was immunohistochemically positive for c-Kit and CD34, and negative for S-100 and α-SMA. A mitotic count showed 3 mitoses per 50 high-power fields. The tumor was diagnosed as a low-risk GIST. The patient's postoperative course was uneventful. GIST in a patient with NF-1 is rare, only 27 cases being reported in the Japanese literature.
报告了1例1型神经纤维瘤病(NF-1)患者经楔形切除术治疗十二指肠胃肠道间质瘤(GIST)的病例。一名有NF-1病史的55岁男性因十二指肠肿瘤入院接受手术。上消化道内镜检查发现一个2.5 cm的十二指肠黏膜下肿瘤。腹部计算机断层扫描显示十二指肠第三段有一个均匀强化的肿块。患者成功接受了十二指肠肿瘤楔形切除术。组织学检查显示梭形肿瘤细胞呈束状排列增殖。该肿瘤免疫组化c-Kit和CD34呈阳性,S-100和α-SMA呈阴性。有丝分裂计数显示每50个高倍视野有3个有丝分裂。该肿瘤被诊断为低风险GIST。患者术后恢复顺利。NF-1患者发生GIST很罕见,日本文献中仅报道了27例。