Stout Annabel, Santharam Lakshmi, Mirza Nazzia
Colorectal Department, New Cross Hospital, Wolverhampton, West Midlands, UK
Colorectal Department, New Cross Hospital, Wolverhampton, West Midlands, UK.
J Surg Case Rep. 2015 Jan 8;2015(1):rju142. doi: 10.1093/jscr/rju142.
Gastrointestinal stromal tumours (GISTs) are rare tumours, making up 0.2-1% of gastrointestinal malignancies [Zakaria and Daradkeh (Jejunojejunal intussusception induced by a gastrointestinal stromal tumour. Case Rep Surg 2012; 2022: :173680)]. Their relative rarity combined with non-specific presentation results in tumours often remaining undiagnosed until surgery or histological examination [Martis et al. (A rare case of jejunojejunal intussusception in an adult. Indian J Surg 2013; 75: (Suppl 1):18-20)]. Presentation as a lead point for intussusception is particularly rare. We present the first case of GIST leading to intussusception at the jejuno-ileal junction in an otherwise well patient prior to presentation. Provisional diagnosis was made during emergency laparotomy, and confirmed through histological analysis. A typical immunohistochemical profile was identified, after which the patient was commenced on adjuvant imatinib therapy. We discuss classical presentation of intussusception and GIST. Further considerations of the investigation and treatment options of GISTs are also presented.
胃肠道间质瘤（GISTs）是罕见肿瘤，占胃肠道恶性肿瘤的0.2 - 1%[扎卡里亚和达拉德凯（胃肠道间质瘤引起的空肠空肠套叠。病例报告外科2012；2022：：173680）]。其相对罕见性与非特异性表现相结合，导致肿瘤往往在手术或组织学检查之前一直未被诊断出来[马尔蒂斯等人（成人罕见的空肠空肠套叠病例。印度外科杂志2013；75：（增刊1）：18 - 20）]。作为套叠的引导点出现尤其罕见。我们报告首例在表现症状之前，一名原本健康的患者发生空肠回肠交界处套叠由胃肠道间质瘤引起的病例。在急诊剖腹手术期间做出初步诊断，并通过组织学分析得以证实。确定了典型的免疫组化特征，之后患者开始接受辅助伊马替尼治疗。我们讨论了套叠和胃肠道间质瘤的经典表现。还提出了对胃肠道间质瘤的检查和治疗选择的进一步思考。
