Dragan Radovanovic, Dejan Stevanovic, Nebojsa Mitrovic, Vinka Vukotic, Predrag Stevanovic, Dragos Stojanovic, Vladan Zivaljevic, Dragoljub Bilanovic
University of Belgrade, Serbia.
Hepatogastroenterology. 2011 Nov-Dec;58(112):2171-4. doi: 10.5754/hge09042.
Gastrointestinal stromal tumors (GIST) represent the most usual mesenchymal tumors of the gastrointestinal tract. In this paper we present a case of a 59-year old patient with an adenocarcinoma of the transversal colon near the lienal flexure without breaking of the intestinal membrane synchronous with an intramural tumor in the antral region of the stomach which was not registered before the operation. Final immunohistochemical findings of the operation specimens: 1. Adenocarcinoma of the large intestine (histological grade I, nuclear grade I, Dukes A, invasion to submucosa) and 2. GIST with low malignant potential. Synchronous appearance of GISTs and colorectal adenocarcinoma, although very rare, has been increasingly observed in the last five years. Because of the small number of cases, a causal connection between these different types of tumors cannot be proven. Through this case report we hope to contribute to the adequate preoperative preparation, operation technique and postoperative monitoring of such patients. Surgical treatment is a dominant way of treating these synchronous tumors, so the surgeon has high responsibility for adequate selection of operative procedure on these patients.
胃肠道间质瘤（GIST）是胃肠道最常见的间叶性肿瘤。本文报告一例59岁患者，其脾曲附近横结肠癌伴肠壁未破裂，同时胃窦部存在术前未发现的壁内肿瘤。手术标本的最终免疫组化结果：1. 大肠腺癌（组织学1级，核分级1级，Dukes A期，侵犯至黏膜下层）；2. 低恶性潜能的GIST。GIST与结直肠癌的同步出现虽然非常罕见，但在过去五年中越来越多地被观察到。由于病例数量较少，无法证实这些不同类型肿瘤之间存在因果关系。通过本病例报告，我们希望为这类患者的充分术前准备、手术技术及术后监测做出贡献。手术治疗是治疗这些同步性肿瘤的主要方式，因此外科医生在为这些患者适当选择手术方式方面负有高度责任。
