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全胃切除术治疗胃脂肪瘤病:一例报告

Gastric lipomatosis treated by total gastrectomy: a case report.

作者信息

Aoyama Shota, Ami Katsunori, Fukuda Akira, Imai Kenichiro, Chong Ja-Mun, Ando Masayuki

机构信息

Department of Surgery, Tokyo Metropolitan Health and Medical Treatment Corporation, Toshima Hospital, 33-1, Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan.

Department of Pathology, Tokyo Metropolitan Health and Medical Treatment Corporation, Toshima Hospital, Tokyo, Japan.

出版信息

Surg Case Rep. 2017 Dec 16;3(1):126. doi: 10.1186/s40792-017-0404-1.

Abstract

BACKGROUND

Gastric lipomatosis is characterized by multiple gastric lipomas or a diffuse gastric infiltration of the submucosal or subserosal layer by the adipose tissue; diffuse-type gastric lipomatosis is an extremely rare condition. Here, we present the case of a patient with gastric lipomatosis treated by total gastrectomy.

CASE PRESENTATION

A 54-year-old man diagnosed with gastric submucosal tumor in 2008 was referred to our hospital for further examination and treatment in September 2016. Upper gastrointestinal endoscopy revealed a submucosal tumor with an associated ulcer on the anterior wall of the lower body of the stomach. A compressing mass was observed on the anterior wall of the greater curvature and the posterior wall of the stomach. Following a biopsy of the submucosal tumor and ulcer, lipoma without malignancy was diagnosed by microscopy. A giant gastric lipoma was suspected because endoscopic ultrasound revealed a high-echoic lesion on the antral wall that extended to the stomach. Therefore, total gastrectomy was performed, and gastric lipomatosis was confirmed by a histological examination of the resected specimen.

CONCLUSIONS

Surgical treatment is a highly effective treatment for symptomatic gastric lipomatosis with extensive involvement or multiple lipomas and can be used for patient diagnosis.

摘要

背景

胃脂肪瘤病的特征为多个胃脂肪瘤或脂肪组织对黏膜下层或浆膜下层的弥漫性胃浸润;弥漫型胃脂肪瘤病极为罕见。在此,我们报告一例接受全胃切除术治疗的胃脂肪瘤病患者。

病例介绍

一名54岁男性,2008年被诊断为胃黏膜下肿瘤,2016年9月转诊至我院进行进一步检查和治疗。上消化道内镜检查显示胃体下部前壁有一个伴有溃疡的黏膜下肿瘤。在胃大弯前壁和胃后壁观察到一个压迫性肿块。对黏膜下肿瘤和溃疡进行活检后,显微镜检查诊断为无恶性的脂肪瘤。由于内镜超声显示胃窦壁上有一个高回声病变并延伸至胃,怀疑为巨大胃脂肪瘤。因此,实施了全胃切除术,切除标本的组织学检查证实为胃脂肪瘤病。

结论

手术治疗对于有症状的、广泛累及或多发脂肪瘤的胃脂肪瘤病是一种高效的治疗方法,可用于患者诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2227/5732123/b1177f49e581/40792_2017_404_Fig1_HTML.jpg

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