Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy.
Int J Surg. 2012;10(9):463-5. doi: 10.1016/j.ijsu.2012.08.015. Epub 2012 Aug 30.
Gastrointestinal stromal tumors (GISTs) arising in the duodenum represent a rare entity and can be very demanding to manage. The diagnosis can be difficult (as these tumors can be misdiagnosed as pancreatic head tumors), and to treat owing to the complex anatomy of the duodenum and of the pancreatic head. Complete resection may require extensive procedures such as pancreaticodudodenectomy.
An extensive literature review regarding clinico-pathological features, diagnostic investigations and surgical options in the management of duodenal GISTs has been performed.
Duodenal GISTs have uncertain malignant potential, and they may be asymptomatic, or present with abdominal pain or bleeding. A preoperative diagnosis can be difficult to obtain. Endoscopic ultrasound and fine needle aspiration cytology (FNAC) may be helpful. Surgical R0 resection remains the only curative approach. However, owing to the complex anatomy of the duodenum, limited resection is not always feasible. In these cases, extensive procedures such as pancreaticoduodenectomy or pancreas-preserving duodenectomy are the treatment of choice.
发生在十二指肠的胃肠道间质瘤（GIST）较为罕见，且难以处理。由于十二指肠和胰头的解剖结构复杂，这些肿瘤可能被误诊为胰头肿瘤，因此诊断和治疗都很困难。为了实现完全切除，可能需要进行胰十二指肠切除术等广泛的手术。
对十二指肠 GIST 的临床病理特征、诊断检查和治疗选择进行了广泛的文献回顾。
十二指肠 GIST 恶性潜能不确定，可能无症状，也可能表现为腹痛或出血。术前诊断可能难以获得。内镜超声和细针抽吸细胞学（FNAC）可能有帮助。R0 切除仍然是唯一的治愈方法。然而，由于十二指肠的解剖结构复杂，不完全切除并不总是可行。在这些情况下，胰十二指肠切除术或保留胰头的十二指肠切除术等广泛手术是首选治疗方法。
