Furukawa Masashi, Izumi Sadanobu, Asano Hiroaki, Tokumo Masaki, Mano Shohey, Shiota Kunihiko
Department of Cancer and Thoracic Surgery, Okayama University Hospital, Okayama City, Okayama, Japan.
Surg Laparosc Endosc Percutan Tech. 2012 Apr;22(2):e109-11. doi: 10.1097/SLE.0b013e3182479e1f.
A 71-year-old man underwent laparoscopic partial gastrectomy for a gastric submucosal tumor in 1997; subsequently, he underwent follow-up without therapy. In December 2008, he noticed a mass at the umbilical wound. Computed tomography and physical examination of the umbilical mass indicated suspected recurrence of the gastric submucosal tumor at the port site. Because the lesion was locally confined, surgery was performed, including resection of the greater omentum; peritoneum; rectus abdominis; and the navel, including the skin. Histologic analysis of the tumor yielded positive results for c-kit, thereby indicating a gastrointestinal stromal tumor (GIST). Mutation analysis of c-kit and platelet-derived growth factor receptor α (PDGFRα) revealed an acquired mutation in exon 18 of PDGFRα in the recurrent tumor. To date, only 4 cases of port-site recurrence after laparoscopic resection of GIST have been reported. This is the first study to report an acquired PDGFRα mutation in port-site recurrence after laparoscopic resection of a GIST.
一名71岁男性于1997年因胃黏膜下肿瘤接受了腹腔镜下胃部分切除术；随后，他接受了随访，未进行治疗。2008年12月，他注意到脐部伤口处有一个肿块。脐部肿块的计算机断层扫描和体格检查表明，胃黏膜下肿瘤疑似在切口部位复发。由于病变局限于局部，遂进行了手术，包括切除大网膜、腹膜、腹直肌以及脐部（包括皮肤）。肿瘤的组织学分析显示c-kit呈阳性，从而表明为胃肠道间质瘤（GIST）。c-kit和血小板衍生生长因子受体α（PDGFRα）的突变分析显示，复发性肿瘤中PDGFRα的第18外显子存在获得性突变。迄今为止，仅报道了4例腹腔镜切除GIST后切口部位复发的病例。本研究首次报道了腹腔镜切除GIST后切口部位复发中存在获得性PDGFRα突变。
