Conte Gabriella A, Harmon Jonathan S, Masia Rachel A, Marchesani Diane, Sun Xiu, Pichardo Elsa Marisol, Parrilla Fernando Brea, Levitt Michael J, Chinnici Angelo A
Department of Medicine, Jersey Shore University Medical Center, Hackensack Meridian Health, Neptune, NJ, USA.
Department of Medicine, Jefferson Health New Jersey, Jefferson University Hospital, Stratford, NJ, USA.
World J Oncol. 2020 Jun;11(3):116-121. doi: 10.14740/wjon1270. Epub 2020 May 14.
Gastrointestinal stromal tumors (GISTs) are the most common type of mesenchymal neoplasm of the gastrointestinal tract but consist of only 1% of all primary gastrointestinal neoplasms. Differentiated from other spindle cell tumors, GISTs are uniquely positive for CD117 expression which allows for molecular targeting therapy with imatinib mesylate (Gleevec). Clinical presentations are variable, ranging from asymptomatic to vague symptoms of abdominal pain, early satiety, abdominal distention or gastrointestinal bleeding. Very rarely, patients can present with tumor-bowel fistula and intra-abdominal abscesses. In this article, we discuss a rare presentation of a middle-aged male with multiple liver abscesses found to have a primary small bowel GIST. This patient received prompt intravenous antibiotics; however, hepatic abscesses can be easily misinterpreted as cystic hepatic metastases which can delay appropriate therapy. was found to be responsible for the formation of the liver abscesses visualized on computed tomography (CT) scan. Similar to , knowledge in the literature is arising about the association between and gastrointestinal malignancies. This case highlights the importance of identifying concomitant primary GISTs with intra-hepatic abscesses, as these lesions can be easily misconstrued as liver metastases and consequently mismanaged. We herein emphasize that hepatic abscesses are a potential sequela of GISTs and should thus prompt further investigation for potential malignancies, if warranted, so that there is no delay in treatment of these gastrointestinal tumors.
胃肠道间质瘤（GISTs）是胃肠道最常见的间叶性肿瘤类型，但仅占所有原发性胃肠道肿瘤的1%。与其他梭形细胞瘤不同，GISTs对CD117表达呈独特阳性，这使得可以用甲磺酸伊马替尼（格列卫）进行分子靶向治疗。临床表现多样，从无症状到腹痛、早饱、腹胀或胃肠道出血等模糊症状。非常罕见的情况下，患者可出现肿瘤-肠瘘和腹腔内脓肿。在本文中，我们讨论了一名中年男性的罕见病例，该患者有多个肝脓肿，经检查发现患有原发性小肠GIST。该患者迅速接受了静脉抗生素治疗；然而，肝脓肿很容易被误诊为肝囊性转移瘤，从而延误适当的治疗。发现[此处原文缺失相关内容]是计算机断层扫描（CT）上所见肝脓肿形成的原因。与[此处原文缺失相关内容]类似，文献中也出现了关于[此处原文缺失相关内容]与胃肠道恶性肿瘤之间关联的知识。该病例强调了识别伴有肝内脓肿的原发性GISTs的重要性，因为这些病变很容易被误解为肝转移瘤，进而导致治疗不当。我们在此强调，肝脓肿是GISTs的潜在后遗症，因此如果有必要，应促使对潜在恶性肿瘤进行进一步调查，以免延误这些胃肠道肿瘤的治疗。
