Takahiro Kinoshita, Takashi Oshiro, Tasuku Urita, Yutaka Yoshida, Mitsuru Ooshiro, Shinichi Okazumi, Ryoji Katoh, Department of Surgery, Toho University Sakura Medical Center, Shimoshizu 564-1, Sakura, 285-8741 Chiba, Japan.
World J Gastrointest Surg. 2010 Nov 27;2(11):385-8. doi: 10.4240/wjgs.v2.i11.385.
We report a case of sporadic gastric carcinoid tumor successfully treated by two-stage laparoscopic surgery. A 38-year old asymptomatic woman was referred to our hospital for evaluation of a submucosal tumor of the stomach. Endoscopic examination showed a solitary submucosal tumor without ulceration or central depression on the posterior wall of the antrum and biopsy specimens were not sufficient to determine the diagnosis. Endoscopic ultrasound revealed a tumor nearly 2 cm in diameter arising from the muscle layer and a computed tomography scan showed the tumor enhanced in the arterial phase. Laparoscopic wedge resection was performed for definitive diagnosis. Pathologically, the tumor was shown to be gastric carcinoid infiltrating the muscle layer which indicated the probability of lymph node metastasis. Serum gastrin levels were normal. As a radical treatment, laparoscopy-assisted distal gastrectomy with regional lymphadenectomy was performed 3 wk after the initial surgery. Finally, pathological examination revealed no lymph node metastasis.
我们报告一例成功通过两阶段腹腔镜手术治疗的散发性胃类癌肿瘤病例。一名 38 岁无症状女性因胃黏膜下肿瘤被转诊至我院。内镜检查显示在后壁的胃窦部有一个孤立的黏膜下肿瘤，无溃疡或中央凹陷，活检标本不足以确定诊断。内镜超声显示直径近 2 厘米的肿瘤起源于肌肉层，计算机断层扫描显示肿瘤在动脉期增强。为明确诊断行腹腔镜楔形切除术。病理检查显示肿瘤浸润肌肉层的胃类癌，提示淋巴结转移的可能性。血清胃泌素水平正常。作为根治性治疗，初始手术后 3 周行腹腔镜辅助远端胃切除术和区域淋巴结清扫术。最终，病理检查显示无淋巴结转移。
