肛管胃肠道间质瘤——1例罕见病例报告及文献复习
Anal canal gastrointestinal stromal tumors - report of a rare case and review of the literature.
作者信息
Paramythiotis D, Bangeas P, Karakatsanis A, Karayannopoulou G, Michalopoulos A
机构信息
1 Propedeutic Surgical Department, A.H.E.P.A. University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Pathology Department, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece.
出版信息
Hippokratia. 2016 Oct-Dec;20(4):313-316.
BACKGROUND
Gastrointestinal stromal tumors (GISTs) are considered as rare gastrointestinal tumors, and their location in the anal track is exceptionally unusual. We describe the case of a 28-year-old man with anal GIST, and a review of the cases that have been reported so far in the literature.
CASE REPORT
The patient was referred for treatment of a gradually enlarging perianal mass. Clinical examination and imaging including orthosigmoidoscopy, transanal ultrasound, and magnetic resonance imaging (MRI) revealed a mass sized 7.5 cm in greatest diameter, in relation with the sphincters, which was excised under general anesthesia. His postoperative course was uneventful and he was discharged on the fourth postoperative day. Pathologic examination revealed characteristics of anal GISTs and further treatment with tyrosine kinase inhibitors was planned.
CONCLUSION
Anal GISTs usually present with rectal bleeding and pain, and only sixteen cases have been reported in the literature. MRI is the radiologic examination of choice, while optimal treatment is considered surgery in combination with adjuvant therapy. Long-term follow-up is necessary. Hippokratia 2016, 20(4): 313-316.
背景
胃肠道间质瘤（GISTs）被认为是罕见的胃肠道肿瘤，其位于肛管部位则极为罕见。我们描述了一例28岁男性肛管GIST病例，并对目前文献中已报道的病例进行回顾。
病例报告
该患者因肛周肿物逐渐增大前来就诊。临床检查及影像学检查，包括直乙状结肠镜检查、经肛门超声检查和磁共振成像（MRI）显示，最大直径为7.5 cm的肿物与括约肌有关，在全身麻醉下将其切除。术后恢复顺利，术后第4天出院。病理检查显示为肛管GIST特征，并计划进一步使用酪氨酸激酶抑制剂治疗。
结论
肛管GIST通常表现为直肠出血和疼痛，文献中仅报道了16例。MRI是首选的影像学检查，而最佳治疗方案为手术联合辅助治疗。需要进行长期随访。《希波克拉底》2016年，20(4): 313 - 316。
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