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巨大的胃肠道间质瘤:迄今为止发现的最大一例胃肠道间质瘤病例。

Gigantic GIST: A Case of the Largest Gastrointestinal Stromal Tumor Found to Date.

作者信息

Mohamed Abdalla, Botros Youssef, Hanna Paul, Lee Sang, Baddoura Walid, Zuberi Jamshed, Damani Tanuja

机构信息

Department of Medicine, St. Joseph's University Medical Center, Paterson, NJ, USA.

Division of Gastroenterology and Hepatology, St. Joseph's University Medical Center, Paterson, NJ, USA.

出版信息

Case Rep Surg. 2018 Sep 30;2018:6170861. doi: 10.1155/2018/6170861. eCollection 2018.

Abstract

Gastrointestinal stromal tumors are uncommon when compared to all gastrointestinal neoplasms but are the most common mesenchymal tumors of the gastrointestinal tract. The largest gastrointestinal stromal tumor ever recorded in literature weighed approximately 6.1 kg and measured 39 cm × 27 cm × 14 cm. About two-thirds of GISTs are malignant. The tumor size, mitotic rate, cellularity, and nuclear pleomorphism are the most important parameters when considering prognosis and recurrence. The definitive treatment for these tumors is resection. In the year 2000, the first patient was treated with the tyrosine kinase inhibitor imatinib and since then, gastrointestinal stromal tumors with high-risk features have been treated successfully with tyrosine kinase inhibitors. We present the largest gastrointestinal stromal tumor recorded in medical literature measuring 42.0 cm × 31.0 cm × 23.0 cm in maximum dimensions and weighing in at approximately 18.5 kg in a 65-year-old African-American male who presented with increased abdominal distention. The mass was successfully excised, and the patient was treated with imatinib without local or distant recurrence 1.5 years postoperatively.

摘要

与所有胃肠道肿瘤相比,胃肠道间质瘤并不常见,但却是胃肠道最常见的间叶性肿瘤。文献记载的最大的胃肠道间质瘤重约6.1千克,尺寸为39厘米×27厘米×14厘米。约三分之二的胃肠道间质瘤是恶性的。在考虑预后和复发时,肿瘤大小、有丝分裂率、细胞密度和核多形性是最重要的参数。这些肿瘤的 definitive 治疗方法是切除。2000年,首例患者接受了酪氨酸激酶抑制剂伊马替尼治疗,自那时起,具有高危特征的胃肠道间质瘤已成功用酪氨酸激酶抑制剂治疗。我们报告了医学文献记载的最大的胃肠道间质瘤,最大尺寸为42.0厘米×31.0厘米×23.0厘米,重约18.5千克,该患者为一名65岁的非裔美国男性,表现为腹胀加重。肿块被成功切除,患者接受伊马替尼治疗,术后1.5年无局部或远处复发。

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