Fraile Alonso Iñaki, López Pardo Rafael
Department of General and Digestive Surgery, Hospital Virgen de la Salud, Avenida Barber nº30, Toledo, Spain.
Int J Surg Case Rep. 2021 Feb;79:14-17. doi: 10.1016/j.ijscr.2020.12.054. Epub 2021 Jan 7.
Carney triad is a rare entity of unknown etiology, characterized by the association of tumors with low incidence such as: gastric leiomyosarcoma, pulmonary chondroma and extra-adrenal paraganglioma. We show a case of Carney triad diagnosed in our center that has some different characteristics to the typical presentation of this patology, and a review of the literature.
We present the case of a 47-year-old men who was admitted to our hospital for upper gastrointestinal bleeding and anemia. The patient was diagnosed of gastric GIST (gastrointestinal stromal tumor), pulmonary nodule and retroperitoneal nodule close to iliac bifurcation. A review of his medical history revealed that he had undergone surgery at 18-year-old for gastric leiomiosarcoma, subtotal gastrectomy performed with gastroenteric anastomosis type Billroth II. The patient underwent total gastrectomy with a end-lateral esophago-jejune mechanical anastomosis and retroperitoneal tumor was also excised. Pathological result confirmed gastric GIST, and extra-adrenal paraganglioma.
We review the available literature to determinate the characteristics and the most appropriate management for this syndrome. The trend is surgical treatment of gastric GIST and paraganglioma, preferred conservative treatment in pulmonary chondroma. It is under discussion whether gastric tumors Carney syndrome is considered GIST, because the Carney triad lesions in stomach are different clinically, pathologically, and etiologically from GIST of stomach.
Carney's triad is a low prevalence entity, with a limited number of publications, so the presentation of the syndrome may be different from the presentation described in the literature.
卡尼三联征是一种病因不明的罕见病症,其特征为伴有低发病率的肿瘤组合,如:胃平滑肌肉瘤、肺软骨瘤和肾上腺外副神经节瘤。我们展示了在本中心诊断出的一例卡尼三联征病例,该病例具有一些与该病症典型表现不同的特征,并对相关文献进行了综述。
我们介绍了一名47岁男性患者,因上消化道出血和贫血入院。该患者被诊断为胃胃肠道间质瘤(GIST)、肺结节以及靠近髂总动脉分叉处的腹膜后结节。回顾其病史发现,他在18岁时因胃平滑肌肉瘤接受过手术,行毕Ⅱ式胃肠吻合的胃次全切除术。该患者接受了食管空肠端侧机械吻合的全胃切除术,并切除了腹膜后肿瘤。病理结果证实为胃GIST和肾上腺外副神经节瘤。
我们回顾了现有文献,以确定该综合征的特征和最合适的治疗方法。趋势是对胃GIST和副神经节瘤进行手术治疗,对肺软骨瘤首选保守治疗。胃肿瘤是否应被视为卡尼综合征的GIST仍在讨论中,因为卡尼三联征在胃中的病变在临床、病理和病因上与胃GIST不同。
卡尼三联征是一种发病率较低的病症,相关出版物数量有限,因此该综合征的表现可能与文献中描述的有所不同。