Qureshi Asim, Al-Moundhri Mansour, Al-Shaibi Maha, Al-Haddabi Ibrahim, Mittal Alok
Department of Pathology, Sultan Qaboos University Hospital, Muscat, Oman.
Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman.
Sultan Qaboos Univ Med J. 2018 Aug;18(3):e383-e385. doi: 10.18295/squmj.2018.18.03.020. Epub 2018 Dec 19.
Primary gastric yolk tumours are extremely rare. We report a 52-year-old male who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in 2017 after having undergone a gastrectomy abroad due to a suspected poorly-differentiated adenocarcinoma. The patient subsequently returned to Oman to receive chemotherapy. However, while undergoing chemotherapy, an abdominal computed tomography scan revealed a lobulated mesenteric mass. Microscopic examination of the resected lesion confirmed a diagnosis of a yolk sac tumour. The mass was diffusely positive for α-fetoprotein (AFP) and a gastric carcinoma stain was negative. Gastrectomy slides from the patient's previous surgery were examined retrospectively. The morphology was typical for a yolk sac tumour and was negative for epithelial markers. An AFP stain showed diffuse immunoreactivity. Thus, the patient was deemed to have had a primary gastric yolk sac tumour which had later metastasised to the mesocolon. Germ cell tumour protocols were initiated and the patient responded well to treatment.
原发性胃卵黄囊瘤极为罕见。我们报告一例52岁男性,2017年因疑似低分化腺癌在国外接受胃切除术后就诊于阿曼马斯喀特的苏丹·卡布斯大学医院。该患者随后返回阿曼接受化疗。然而,在化疗期间,腹部计算机断层扫描显示一个分叶状肠系膜肿块。对切除病变的显微镜检查确诊为卵黄囊瘤。肿块α-甲胎蛋白(AFP)弥漫性阳性,胃癌染色阴性。对患者之前手术的胃切除切片进行回顾性检查。形态学表现为典型的卵黄囊瘤,上皮标志物阴性。AFP染色显示弥漫性免疫反应。因此,该患者被认为患有原发性胃卵黄囊瘤,后来转移至结肠系膜。启动了生殖细胞肿瘤治疗方案,患者对治疗反应良好。