Nagai Takeshi, Ueda Kazumitsu, Hakoda Hiroyuki, Okata Shinya, Nakata Shoko, Taira Tetsuro, Aoki Shigeo, Mishima Hideyuki, Sako Akihiro, Maruyama Tsunehiko, Okumura Minoru
Department of Surgery, Hitachi General Hospital, 2-1-1 Jonan-cho, Hitachi, Ibaraki, 317-0077, Japan.
Surg Case Rep. 2016 Dec;2(1):87. doi: 10.1186/s40792-016-0218-6. Epub 2016 Sep 1.
Recently, gastrointestinal stromal tumors that have developed outside of the digestive tract have been reported. These tumors are collectively termed extra-gastrointestinal stromal tumors. Extra-gastrointestinal stromal tumors can also develop in the liver. Only eight case reports involving primary GIST of the liver have been published. We report a case and review the literature regarding this disease.
A 70-year-old woman with a past history of gastric cancer visited our hospital for regular inspection. With extensive radiological imaging, a computed tomography scan revealed a mass with a size of 6.8 cm in the lateral segment of the liver. (18)F-Fluoro-2-deoxyglucose positron emission tomography revealed no other malignancies except for the liver tumor. Because the lesion was suspected of being a primary malignant hepatic tumor, lateral segmentectomy was performed. The immunohistochemical analysis supported the diagnosis of gastrointestinal stromal tumors in the liver. The patient has had no evidence of recurrence during the 10-month follow-up period; imatinib chemotherapy was not administered.
Primary hepatic gastrointestinal stromal tumors had no characteristics that distinguished them from ordinary tumors in imaging examinations. Primary gastrointestinal stromal tumors might have developed from interstitial Cajal-like cells.
最近,有报道称在消化道外发生的胃肠道间质瘤。这些肿瘤统称为胃肠道外间质瘤。胃肠道外间质瘤也可发生于肝脏。仅有8例关于原发性肝脏胃肠道间质瘤的病例报告发表。我们报告1例病例并回顾关于该疾病的文献。
一名有胃癌病史的70岁女性因定期检查来我院就诊。经广泛的放射影像学检查,计算机断层扫描显示肝脏外侧段有一个大小为6.8 cm的肿块。氟代脱氧葡萄糖正电子发射断层扫描显示除肝脏肿瘤外无其他恶性肿瘤。由于该病变怀疑是原发性恶性肝肿瘤,遂行外侧段切除术。免疫组织化学分析支持肝脏胃肠道间质瘤的诊断。在10个月的随访期内,患者无复发迹象;未给予伊马替尼化疗。
原发性肝脏胃肠道间质瘤在影像学检查中没有与普通肿瘤相区别的特征。原发性胃肠道间质瘤可能起源于间质 Cajal 样细胞。