de'Angelis Nicola, Memeo Riccardo, Zuddas Valeria, Mehdaoui Dalila, Azoulay Daniel, Brunetti Francesco
Digestive and Liver Transplant Surgery Unit, Henri-Mondor Hospital, Université Paris Est, 51 avenue du Maréchal de Lattre de Tassigny, 94010 Créteil, France.
World J Surg Oncol. 2014 Mar 29;12:76. doi: 10.1186/1477-7819-12-76.
Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors that originate from interstitial cells of Cajal or their stem cell-like precursors. Generally, GISTs have specific c-KIT gene mutations. The incidence of GISTs is estimated to be 10 to 20 cases/one million individuals, and GISTs typically affect people over 50 years of age. The majority of GISTs are solitary. However, multifocal GISTs have been observed, especially in children. We report on two unusual adult cases of double GISTs that were treated by laparoscopic surgery. The first patient presented a polypoid mass of the fundus and a second isolated smaller tumor in the posterior wall of the lesser curvature of the stomach. A histopathological examination confirmed that both tumors were GISTs and were c-KIT-positive. A total laparoscopic gastrectomy was performed. In the second patient, GISTs were identified at the level of the fundus and the greater curvature of the stomach. A laparoscopic partial sleeve gastrectomy was performed. Both surgeries were successful with no complications or relapses at three to five years following surgery.
胃肠道间质瘤（GISTs）是起源于 Cajal 间质细胞或其干细胞样前体的间叶组织肿瘤。一般来说，GISTs 具有特定的 c-KIT 基因突变。据估计，GISTs 的发病率为每 100 万人中有 10 至 20 例，且 GISTs 通常影响 50 岁以上的人群。大多数 GISTs 是单发的。然而，也观察到有多灶性 GISTs，尤其是在儿童中。我们报告了两例不同寻常的成年双发 GISTs 病例，均接受了腹腔镜手术治疗。第一例患者胃底有一个息肉样肿物，胃小弯后壁还有一个孤立的较小肿瘤。组织病理学检查证实这两个肿瘤均为 GISTs，且 c-KIT 呈阳性。遂行全腹腔镜胃切除术。第二例患者胃底和胃大弯处发现 GISTs。实施了腹腔镜部分袖状胃切除术。两台手术均成功，术后三至五年无并发症或复发。
