Kerkez Mirko D, Lekić Nebojsa S, Culafić Djordje M, Raznatović Zoran J, Ignjatović Igor I, Lekić Dragana D, Mijac Dragana D
University of Belgrade, School of Medicine, Clinical Center of Serbia, Clinic of Surgery, Belgrade, Serbia.
Vojnosanit Pregl. 2011 Jun;68(6):519-22. doi: 10.2298/vsp1106519k.
Gastric adenomyoma is a rare, hamartomatous tumor localized most frequently in the gastric antrum. Review of the available literature shows only sporadic reports or smaller series.
We presented a 72-year-old woman admitted due to epigastric pain with dyspeptic difficulties. Biochemical parameters and tumor markers were within the referential limits. Diagnostic procedures (upper endoscopy, endoscopic ultrasonography and computerized tomography) revealed an intramural tumor prominence with intact mucosa on the posterior wall of gastric antrum, not accessible for biopsy. Surgical treatment was performed with total extirpation of the tumor. Histopathological examination verified adenomyoma with focal low grade epithelial dysplasia. Cytologic immunophenotype was consistent with smooth muscle stromal and epithelial tumor (CK7 and CK20 ++ immunophenotype). Stromal component revealed low proliferative index (Ki-67 protein immunoexpression level 3%), and p53 less than 0.1% in both epithelial and stromal components. Following the operation, the patient remained in good condition.
Uncertain malignant potential of the gastric adenomyoma in the presented case indicates that timely diagnostics with adequate surgical treatment is crucial for an adequate treatment.
胃腺肌瘤是一种罕见的错构瘤性肿瘤，最常位于胃窦部。查阅现有文献仅见零星报道或较小系列病例。
我们报告了一名72岁女性，因上腹部疼痛伴消化不良前来就诊。生化指标和肿瘤标志物均在参考范围内。诊断性检查（上消化道内镜检查、内镜超声检查和计算机断层扫描）显示胃窦后壁有一壁内肿瘤突出，黏膜完整，无法进行活检。遂行手术完整切除肿瘤。组织病理学检查证实为腺肌瘤伴局灶性低级别上皮发育异常。细胞免疫表型与平滑肌间质及上皮肿瘤一致（CK7和CK20 ++免疫表型）。间质成分增殖指数较低（Ki-67蛋白免疫表达水平为3%），上皮和间质成分中p53均低于0.1%。术后患者情况良好。
本病例中胃腺肌瘤的恶性潜能不确定，这表明及时诊断并进行适当的手术治疗对于充分治疗至关重要。
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