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一例以发热为主诉诊断的原发性胃未分化高级别多形性肉瘤:病例报告及文献复习

A case of primary gastric undifferentiated high-grade pleomorphic sarcoma diagnosed with chief complaint of fever: a case report and literature review.

作者信息

Kabashima Akira, Kimura Koichi, Sanefuji Kensaku, Masunari Satoru, Haraoka Seiji, Maekawa Soichiro

机构信息

Department of Surgery, Munakata Medical Association Hospital, 5-3-3 Taguma, Munakata, Fukuoka, 811-3431, Japan.

Department of Radiology, Munakata Medical Association Hospital, 5-3-3 Taguma, Munakata, Fukuoka, 811-3431, Japan.

出版信息

Surg Case Rep. 2017 Dec;3(1):41. doi: 10.1186/s40792-017-0317-z. Epub 2017 Mar 8.

Abstract

BACKGROUND

Undifferentiated high-grade pleomorphic sarcoma in gastrointestinal tract is extremely rare, and its prognosis is poor.

CASE PRESENTATION

An 82-year-old man visited a previous hospital complaining of fever, general fatigue, and shaking chill, for which he received antibiotics therapy. As the fever continued, he was referred to our hospital, where computed tomography and upper gastrointestinal endoscopy showed a 6-cm gastric tumor. A preoperative biopsy was consistent with a malignant mesenchymal tumor, but could not provide a definitive pathological diagnosis nor prove a cause-and-effect relationship between the chief complaint and the gastric tumor. The gastric tumor had grown to 8 cm in diameter within a month so we performed a partial gastrectomy. The pathological postoperative diagnosis was undifferentiated high-grade pleomorphic sarcoma that produced granulocyte colony-stimulating factor. The patient's fever quickly improved, and he showed a good postoperative course.

CONCLUSIONS

We herein report a case of rapidly growing, undifferentiated, high-grade pleomorphic gastric sarcoma, which presented as a chief complaint of fever.

摘要

背景

胃肠道未分化高级别多形性肉瘤极为罕见,预后较差。

病例介绍

一名82岁男性因发热、全身乏力及寒战前往之前的医院就诊,接受了抗生素治疗。由于发热持续,他被转诊至我院,计算机断层扫描和上消化道内镜检查显示胃内有一个6厘米的肿瘤。术前活检结果符合恶性间叶性肿瘤,但无法提供明确的病理诊断,也无法证明主要症状与胃肿瘤之间存在因果关系。胃肿瘤在一个月内直径增长至8厘米,因此我们进行了部分胃切除术。术后病理诊断为产生粒细胞集落刺激因子的未分化高级别多形性肉瘤。患者的发热迅速好转,术后恢复良好。

结论

我们在此报告一例以发热为主要症状的快速生长的、未分化的、高级别胃多形性肉瘤病例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/670f/5342989/34837afd6217/40792_2017_317_Fig1_HTML.jpg

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