Yamashita Kohei, Baba Yoshifumi, Kurashige Junji, Iwatsuki Masaaki, Imai Katsunori, Hashimoto Daisuke, Sakamoto Yasuo, Chikamoto Akira, Yoshida Naoya, Beppu Toru, Baba Hideo
Department of Gastroenterological Surgery, Kumamoto University Graduate School of Medical Sciences, 1-1-1 Honjo, Chuo-ku, Kumamoto City, 860-8556, Japan.
Surg Case Rep. 2016 Dec;2(1):86. doi: 10.1186/s40792-016-0212-z. Epub 2016 Sep 1.
Gastrointestinal stromal tumors (GISTs) are potentially malignant mesenchymal tumors that can give rise to distant metastases, mainly in the liver. The co-occurrence of synchronous primary liver tumors (e.g., hepatocellular carcinoma (HCC)) in patients with GIST is extremely rare. This report describes a 77-year-old male patient with liver metastasis of GIST originating in the small intestine and synchronous HCC. The patient had undergone resection of the small intestine for the primary GIST 3 years earlier and partial hepatectomy and radiofrequency ablation for liver metastases of GIST 1 year earlier. Despite the continuation of adjuvant therapy with imatinib, two new lesions in the liver were detected by follow-up computed tomography scanning, which showed the gradual enlargement of one tumor. A second hepatectomy was performed. Pathological examination revealed that one tumor was a liver metastasis of GIST and the other was a primary HCC. To our knowledge, this is the first report of the synchronous co-occurrence of a liver metastasis of GIST and a primary HCC.
胃肠道间质瘤（GISTs）是具有潜在恶性的间叶性肿瘤，可发生远处转移，主要转移至肝脏。GIST患者同时出现原发性肝肿瘤（如肝细胞癌（HCC））的情况极为罕见。本报告描述了一名77岁男性患者，患有起源于小肠的GIST肝转移及同步发生的HCC。该患者3年前因原发性GIST接受了小肠切除术，1年前因GIST肝转移接受了部分肝切除术和射频消融术。尽管继续使用伊马替尼进行辅助治疗，但随访计算机断层扫描发现肝脏出现两个新病灶，其中一个肿瘤逐渐增大。遂进行了第二次肝切除术。病理检查显示，一个肿瘤为GIST肝转移灶，另一个为原发性HCC。据我们所知，这是首例关于GIST肝转移与原发性HCC同步发生的报告。
