Antić Vasilije, Micev Marjan, Baskić Danijela, Mladenović Violeta
Med Pregl. 2014 Jan-Feb;67(1-2):55-9.
Gastrointestinal stromal tumors are the most common mesenchymal neoplasms of the gastrointestinal tract. These tumors represent more than 80% of all mesenchymal tumors found in the gastrointestinal tract, though they account for only approximately 3% of all gastrointestinal malignancies. Literature offers case reports, which describe symptomatic gastrointestinal stromal tumors and they generally represent patients with larger tumors.
We present the case of a small gastrointestinal stromal tumor in a 40-year-old man, with associated giant liver hemangioma and fever, and with history of abdominal discomfort and fever. Clinical examination revealed hepatosplenomegaly, palpable mass in the right lower abdomen, and signs of neurofibromatosis type 1 (Morbus von Recklinghausen). Computed tomography revealed a giant tumor in the right lobe of the liver. Magnetic resonance showed abscess in the hemangioma of the liver. An intestinal tumor was incidentally found and excised during surgical laparotomy. An intestinal gastrointestinal stromal tumor was revealed by histopathology and confirmed by immunohistochemistry. Although a multidisciplinary team proposed surgical removal of the liver tumor mass, the surgeons decided to follow up the patient because of a high risk of new intervention.
According to the available data, this is a very rare case of small intestinal gastrointestinal stromal tumor, with symptoms of fever and giant abscess in the liver hemangioma.
胃肠道间质瘤是胃肠道最常见的间叶性肿瘤。这些肿瘤占胃肠道所有间叶性肿瘤的80%以上,尽管它们仅占所有胃肠道恶性肿瘤的约3%。文献中有病例报告描述了有症状的胃肠道间质瘤,这些病例通常是肿瘤较大的患者。
我们报告一例40岁男性的小肠胃肠道间质瘤病例,伴有巨大肝血管瘤和发热,有腹部不适和发热病史。临床检查发现肝脾肿大,右下腹可触及肿块,以及1型神经纤维瘤病(冯·雷克林豪森病)体征。计算机断层扫描显示肝脏右叶有一个巨大肿瘤。磁共振成像显示肝血管瘤内有脓肿。在手术剖腹探查时偶然发现并切除了一个肠道肿瘤。组织病理学显示为肠道胃肠道间质瘤,并经免疫组织化学证实。尽管多学科团队建议手术切除肝脏肿瘤肿块,但由于再次干预风险高,外科医生决定对患者进行随访。
根据现有数据,这是一例非常罕见的小肠胃肠道间质瘤病例,伴有发热症状和肝血管瘤内巨大脓肿。