Ishizaki Masahiro, Uno Futoshi, Yoshida Ryosuke, Miyauchi Shunsaku, Honda Osamu
Department of Surgery, Okayama Rosai Hospital, Okayama, Japan.
Department of Surgery, Okayama Rosai Hospital, Okayama, Japan.
Int J Surg Case Rep. 2020;76:156-160. doi: 10.1016/j.ijscr.2020.09.155. Epub 2020 Sep 28.
Recurrent forms of gastrointestinal stromal tumor (GIST) include liver metastases and peritoneal dissemination. Recurrence often occurs within 2 years. We report a case of liver metastasis, which was detected 30 years after resection of a primary lesion in the small intestine and was resected 32 years later.
The patient was a 72-year-old woman and was being followed up for ureteral stones at the department of urology of our hospital. Computed tomography (CT) showed a small mass in segment 7 of the liver, 2 years ago. As the tumor gradually increased, a biopsy was performed, and a mesenchymal tumor was diagnosed. The tumor continued to increase in size and partial hepatectomy was performed. GIST was suspected from the sample extracted during hepatectomy. The patient had undergone a resection of the small intestine for a tumor 32 years ago. On tracing her medical records, it was confirmed that resection of the small intestine was performed for the diagnosis of leiomyosarcoma.
Based on the block specimen from 32 years ago, the tumor of the intestine was confirmed to be GIST, and the liver mass was finally diagnosed as liver metastasis of the GIST that had occurred 32 years ago.
We experienced a case of liver metastasis 32 years after surgery for the first small intestinal GIST. To the best of our knowledge, this case had the longest disease-free interval before metastasis to the liver.
胃肠道间质瘤（GIST）的复发形式包括肝转移和腹膜播散。复发常发生在2年内。我们报告一例肝转移病例，该病例在小肠原发性病变切除30年后被发现，并在32年后进行了切除。
患者为一名72岁女性，因输尿管结石在我院泌尿外科接受随访。2年前计算机断层扫描（CT）显示肝脏第7段有一个小肿块。随着肿瘤逐渐增大，进行了活检，诊断为间叶性肿瘤。肿瘤继续增大，遂行部分肝切除术。肝切除术中提取的样本怀疑为GIST。患者32年前因肿瘤接受过小肠切除术。追溯其病历，证实小肠切除术是为诊断平滑肌肉瘤而进行的。
根据32年前的块状标本，肠道肿瘤确诊为GIST，肝脏肿块最终诊断为32年前发生的GIST肝转移。
我们遇到了一例首次小肠GIST手术后32年发生肝转移的病例。据我们所知，该病例在肝转移前的无病间隔时间最长。
