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腹腔镜远端胃切除术治疗胃球瘤:一例报告

Glomus tumor of the stomach treated by laparoscopic distal gastrectomy: A case report.

作者信息

Namikawa Tsutomu, Tsuda Sachi, Fujisawa Kazune, Iwabu Jun, Uemura Sunao, Tsujii Shigehiro, Maeda Hiromichi, Kitagawa Hiroyuki, Kobayashi Michiya, Hanazaki Kazuhiro

机构信息

Department of Surgery, Kochi Medical School, Nankoku, Kochi 783-8505, Japan.

Cancer Treatment Center, Kochi Medical School Hospital, Nankoku, Kochi 783-8505, Japan.

出版信息

Oncol Lett. 2019 Jan;17(1):514-517. doi: 10.3892/ol.2018.9621. Epub 2018 Oct 25.

Abstract

Glomus tumor of the stomach is a rare submucosal mesenchymal tumor. The present study reports a patient with gastric glomus tumor treated by laparoscopic distal gastrectomy. A 39-year-old male was referred to Kochi Medical School Hospital for examination of a gastric submucosal tumor (SMT) initially diagnosed following a medical check-up. Esophagogastroduodenoscopy revealed a solitary, well-defined, submucosal lesion in the antrum of the stomach. Endoscopic ultrasonography (EUS) revealed a hypoechoic solid mass primarily connected to the gastric muscular layer. Abdominal contrast-enhanced computed tomography confirmed a 1.5 cm, well-defined mass lesion demonstrating homogeneous strong enhancement in the gastric antrum. Subsequent EUS-guided fine-needle aspiration produced a clinical diagnosis of neuroendocrine neoplasm and the patient underwent laparoscopic distal gastrectomy with regional lymph node dissection. Histopathology revealed solid proliferation of round, α-smooth muscle actin-immunopositive tumor cells with dilated vessels lined by endothelial cells without atypia, prompting a diagnosis of gastric glomus tumor. To the best of our knowledge, this is the seventh case of gastric glomus tumor treated by laparoscopy reported in English literature. The present case suggested that glomus tumor should be considered in the differential diagnosis for SMT of the stomach.

摘要

胃血管球瘤是一种罕见的黏膜下间叶组织肿瘤。本研究报告了一例接受腹腔镜远端胃切除术治疗的胃血管球瘤患者。一名39岁男性因体检时初步诊断出胃黏膜下肿瘤(SMT)而被转诊至高知医科大学医院。食管胃十二指肠镜检查发现胃窦部有一个孤立的、边界清晰的黏膜下病变。内镜超声检查(EUS)显示一个低回声实性肿块,主要与胃肌层相连。腹部增强计算机断层扫描证实胃窦部有一个1.5厘米、边界清晰的肿块病变,表现为均匀的强烈强化。随后的EUS引导下细针穿刺活检得出神经内分泌肿瘤的临床诊断,该患者接受了腹腔镜远端胃切除术及区域淋巴结清扫术。组织病理学显示圆形的、α-平滑肌肌动蛋白免疫阳性的肿瘤细胞呈实性增生,血管扩张,内衬无异型性的内皮细胞,从而诊断为胃血管球瘤。据我们所知,这是英文文献中报道的第七例通过腹腔镜治疗的胃血管球瘤病例。本病例提示,胃SMT的鉴别诊断应考虑血管球瘤。

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