Bormann Fabian, Wild Wolfgang, Aksoy Hüseyin, Dörr Pius, Schmeck Sanja, Schwarzbach Matthias
Klinik für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie, Klinikum Frankfurt Höchst, Gotenstraße 6-8, 65929 Frankfurt am Main, Germany.
Klinik für Radiologie, Neuroradiologie und Nuklearmedizin, Klinikum Frankfurt Höchst, Gotenstraße 6-8, 65929 Frankfurt am Main, Germany.
Case Rep Med. 2014;2014:420295. doi: 10.1155/2014/420295. Epub 2014 Sep 10.
Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors of the gastrointestinal tract that originate from the intestinal cells of Cajal (ICC) (Fletcher et al., 2002). Only a few cases have been described with extragastrointestinal stromal tumors (Kim et al., 2012; Soufi et al., 2013; Meng et al., 2011). They are often diagnosed as a pancreatic head tumor as they are very difficult to relate to the duodenum with CT, MRI, or ultrasound. We present a case of a sixty-four-year-old woman who presented with abdominal pain and cardialgia for a follow-up examination after breast cancer surgery. On laparotomy there was a 3 × 5 cm hypervascular mass arising from the pancreatic head with macroscopically no attachment to the duodenum. The patient underwent pancreatoduodenectomy (PD) modified after Traverso-Longmire, histopathology proved a duodenal GIST. This case proves that duodenal GISTs can grow invasively into the pancreas and appear as solid pancreas head tumor; therefore, these tumors should be included into differential diagnosis.
胃肠道间质瘤（GISTs）是一种罕见的胃肠道间充质肿瘤，起源于 Cajal 细胞（ICC）（Fletcher 等人，2002 年）。仅有少数关于胃肠道外间质瘤的病例报道（Kim 等人，2012 年；Soufi 等人，2013 年；Meng 等人，2011 年）。它们常被诊断为胰头肿瘤，因为通过 CT、MRI 或超声很难将其与十二指肠联系起来。我们报告一例 64 岁女性病例，该患者在乳腺癌手术后因腹痛和胃痛前来进行随访检查。剖腹手术时发现一个 3×5cm 的高血运肿块，起源于胰头，肉眼观察与十二指肠无粘连。患者接受了经 Traverso-Longmire 改良的胰十二指肠切除术（PD），组织病理学证实为十二指肠 GIST。该病例证明十二指肠 GIST 可侵袭性生长至胰腺，并表现为实性胰头肿瘤；因此，这些肿瘤应纳入鉴别诊断。
