Ogawa Hisataka, Gotoh Kunihito, Yamada Terumasa, Takahashi Hidenori, Ohigashi Hiroaki, Nagata Shigenori, Tomita Yasuhiko, Yano Masahiko, Ishikawa Osamu
Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
Case Rep Gastroenterol. 2012 May;6(2):375-80. doi: 10.1159/000337908. Epub 2012 Jun 19.
We report the unique case of a 69-year-old man with an extra-gastrointestinal stromal tumor (EGIST) in the lesser omentum. Based on the location of the tumor and the radiological findings, we made a provisional diagnosis of hepatic cavernous hemangioma in the lateral segment. However, after 5 years of follow-up, tumor growth was noted and the patient underwent a laparotomy. The tumor was located in the lesser omentum and resected en bloc with its fused lesser omentum and an adherent portion of the liver. The pathology results indicated an EGIST with microscopic proliferation of epithelioid cells in the lesser omentum; the tumor was immunohistochemically negative for KIT staining and positive for CD34 and PKC theta. Because of the rarity of mitotic figures and the low Ki-67 labeling, the tumor was diagnosed as a KIT-negative EGIST with a low malignant potential. The patient was followed up without receiving imatinib mesylate treatment and has remained free of any signs of recurrence for 26 months. The present case report describes a very rare lesser omental KIT-negative EGIST.
我们报告了一例罕见病例,一名69岁男性在小网膜处患有胃肠道外间质瘤(EGIST)。根据肿瘤的位置和影像学检查结果,我们初步诊断为肝外侧段海绵状血管瘤。然而,经过5年的随访,发现肿瘤生长,患者接受了剖腹手术。肿瘤位于小网膜,连同融合的小网膜和肝脏的粘连部分整块切除。病理结果显示为小网膜处的EGIST,伴有上皮样细胞的显微镜下增殖;肿瘤KIT染色免疫组化阴性,CD34和PKCθ阳性。由于有丝分裂象罕见且Ki-67标记率低,该肿瘤被诊断为具有低恶性潜能的KIT阴性EGIST。患者未接受甲磺酸伊马替尼治疗进行随访,26个月来一直无任何复发迹象。本病例报告描述了一种非常罕见的小网膜KIT阴性EGIST。