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直肠腺癌合并偶然发现的微小胃肠道间质瘤:一例报告。

Rectal adenocarcinoma coexisting with incidentally found microscopic gastrointestinal stromal tumor: A case report.

作者信息

Xue Wangsheng, Li Yongbo, Wang Shuang, Yu Ke, Yu Jiaqi, Zhao Zeyun, Jiang Dan, Zhang Mingwei, Liu Tongjun, Wang Min

机构信息

Department of the General Surgery.

Department of Dermatology, The Second Hospital of Jilin University, Changchun, Jilin, China.

出版信息

Medicine (Baltimore). 2019 Aug;98(31):e16644. doi: 10.1097/MD.0000000000016644.

Abstract

RATIONALE

Adenocarcinoma coexists with adjacent microscopic gastrointestinal stromal tumor (micro-GIST) is rare, especially in the rectum, where the gastrointestinal stromal tumors (GISTs) have the lower incidence rate. It is easy to ignore the concurrent micro-GIST due to the untypical symptoms.

PATIENT CONCERNS

A 77-year-old male patient suffered from lower abdominal pain for 20 days and presented with per rectal bleeding for 10 days. He had the medical history of hypertension and diabetes for more than 25 years.

DIAGNOSES

Endoscopy revealed that the patient had rectum adenocarcinoma and multiple rectum polyps. Besides, the gastrointestinal stromal tumor was diagnosed by the pathologist.

INTERVENTIONS

The patient underwent surgery of laparoscopic rectum resection and prophylactic ileostomy and took 6 courses of Capecitabine tablets orally.

OUTCOMES

One year after surgery, the patient had no local relapse by the CT scan. However, not long after the CT examination, he died of cardiovascular disease.

LESSONS

Although micro-GIST may be noninvasive and asymptomatic, it may have the potential for transforming to malignancies. More attention should be paid to the patients diagnosed with gastrointestinal malignancy coexisting with micro-GIST.

摘要

理论依据

腺癌与相邻的微小胃肠道间质瘤(micro-GIST)共存的情况罕见,尤其是在直肠,胃肠道间质瘤(GIST)在直肠的发病率较低。由于症状不典型,并发的微小GIST容易被忽视。

患者情况

一名77岁男性患者下腹痛20天,直肠出血10天。他有25年以上的高血压和糖尿病病史。

诊断

内镜检查显示患者患有直肠腺癌和多个直肠息肉。此外,病理学家诊断为胃肠道间质瘤。

干预措施

患者接受了腹腔镜直肠切除术和预防性回肠造口术,并口服了6个疗程的卡培他滨片。

结果

术后一年,CT扫描显示患者无局部复发。然而,CT检查后不久,他死于心血管疾病。

经验教训

尽管微小GIST可能无侵袭性且无症状,但它可能有恶变的潜能。对于诊断为胃肠道恶性肿瘤并伴有微小GIST的患者应给予更多关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/788d/6708707/5e5370e8aa57/medi-98-e16644-g001.jpg

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