Valéry Refeno, Emile Hasiniatsy Nomeharisoa Rodrigue, Nasandratriniavo Ramahandrisoa Andriatsihoarana Voahary, Manitrala Ramanampamonjy Rado, Hervé Samison Luc, Florine Rafaramino
Department of Oncology, Professor Zafisaona Gabriel Teaching Hospital, Mahajanga, Faculty of Medicine of Mahajanga, Mahajanga , Madagascar.
Department of Oncology and Palliative Care, Military Hospital Antananarivo, Faculty of Medicine of Antananarivo, Antananarivo, Madagascar.
Pan Afr Med J. 2019 Dec 16;34:197. doi: 10.11604/pamj.2019.34.197.19373. eCollection 2019.
Gastrointestinal stromal tumors are the most common mesenchymal tumors of the gastrointestinal tract. They are generally considered as solitary tumors. Here we report the case of a 66-year-old man with familial history of digestive cancers, admitted after a 2-months history of gastrointestinal bleeding. Colonoscopy showed a circumferential ulcerated tumor of the sigmoid which was a well differentiated adenocarcinoma on biopsy. Computerized tomography showed only the lesion of the sigmoid. The patient underwent a left colectomy followed by immediate end-to-end anastomosis. Per-operatively, jejunal mass was discovered and a jejunal segmentectomy was performed. Pathologic examination revealed a colic adenocarcinoma pT2N0M0 associated with a low risk stromal tumor of the jejunum CD117+ and DOG-1+. No adjuvant therapy was given. After 64 months of follow-up, the patient showed no evidence of recurrence. Clinicians should be aware of the coexistence of malignancies and carry careful investigations for accurate diagnosis and better patients' prognosis.
胃肠道间质瘤是胃肠道最常见的间叶组织肿瘤。它们通常被认为是孤立性肿瘤。在此,我们报告一例66岁男性患者,有消化道癌症家族史,因2个月的胃肠道出血病史入院。结肠镜检查显示乙状结肠有一环形溃疡性肿瘤,活检显示为高分化腺癌。计算机断层扫描仅显示乙状结肠病变。患者接受了左半结肠切除术,随后立即进行端端吻合术。术中发现空肠肿物,并进行了空肠节段切除术。病理检查显示为结肠腺癌pT2N0M0,伴有空肠低风险间质瘤,CD117+和DOG-1+。未给予辅助治疗。随访64个月后,患者无复发迹象。临床医生应意识到恶性肿瘤的共存,并进行仔细检查以准确诊断并改善患者预后。