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胃高危胃肠道间质瘤与腹膜后脂肪肉瘤——两种间叶性肿瘤病变在诊断和治疗方面具有挑战性的组合。

Gastric high-risk gist and retroperitoneal liposarcoma--a challenging combination of two mesenchymal tumor lesions with regard to diagnosis and treatment.

作者信息

Arend Jőrg, Kuester Doerthe, Roessner Albert, Lippert Hans, Meyer Frank

出版信息

Pol Przegl Chir. 2013 May;85(5):284-8. doi: 10.2478/pjs-2013-0043.

Abstract

Both gastrointestinal stromal tumors (GIST) and liposarcoma originate from mesenchymal tissue. Their coincidence requires a specific expertise in the diagnostic and therapeutic management. An unusual exemplary case is described representing a 47-year old female patient with a gastric GIST and a monstrous retroperitoneal liposarcoma with infiltration of the left kidney. The gastric tumor lesion was removed with a tangential resection of the gastric wall; the retroperitoneal tumor lesion was resected including the left kidney. Both tumors were resected with no macroscopic tumor residual. The technically difficult surgical intervention did not show any postoperative complication, and the postoperative course was also uneventful. The complete tumor resection is the treatment of choice in mesenchymal tumors (aim: R0). Depending on histologic tumor classification, resection status and tumor sensitivity, a subsequent radiation and/or chemotherapy is necessary, which allowed to achieve a postoperative tumor-free survival of 6 years including a good quality of life.

摘要

胃肠道间质瘤(GIST)和脂肪肉瘤均起源于间叶组织。它们的并存需要在诊断和治疗管理方面具备特定的专业知识。本文描述了一个不寻常的典型病例,该病例为一名47岁女性患者,患有胃GIST和巨大的腹膜后脂肪肉瘤并侵犯左肾。胃肿瘤病变通过胃壁的切线切除术切除;腹膜后肿瘤病变连同左肾一并切除。两个肿瘤均被切除,无肉眼可见的肿瘤残留。技术难度较大的手术干预未出现任何术后并发症,术后病程也平稳。完整的肿瘤切除是间叶组织肿瘤的首选治疗方法(目标:R0)。根据肿瘤的组织学分类、切除状态和肿瘤敏感性,后续需要进行放疗和/或化疗,这使得患者术后无瘤生存6年,生活质量良好。

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