一例罕见的转移性默克尔细胞癌累及胃和胰腺，表现为上消化道出血和梗阻性黄疸。
A Rare Case of Metastatic Merkel Cell Carcinoma to the Stomach and Pancreas Presenting With Upper Gastrointestinal Bleeding and Obstructive Jaundice.
作者信息
Elkafrawy Ahmed, Numan Laith, Albawaliz Anas, Liu Cynthia, Bahaj Waled, Tawfik Ossama, Hamid Fadi
机构信息
Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, OH.
Internal Medicine Department, University of Missouri Kansas City School of Medicine, Kansas City, MO.
出版信息
ACG Case Rep J. 2021 Jan 27;8(1):e00523. doi: 10.14309/crj.0000000000000523. eCollection 2021 Jan.
Merkel cell carcinoma (MCC) is a rare and aggressive primary neuroendocrine tumor of the skin. Gastrointestinal (GI) metastasis in MCC is uncommon. We present a case of MCC with metastasis to the stomach, duodenum, and pancreas presenting with melena and obstructive jaundice. A large, bleeding metastatic mass was identified in the duodenum. Hemostasis was achieved with coil embolization. Endoscopic retrograde cholangiopancreatography with stenting of the common bile duct was performed to relieve the obstruction. Close surveillance with positron emission tomography/computed tomography scan and possible GI endoscopy should be performed in cases with distant metastasis to identify and treat early GI tract lesions.
默克尔细胞癌（MCC）是一种罕见的侵袭性皮肤原发性神经内分泌肿瘤。MCC发生胃肠道转移并不常见。我们报告一例MCC转移至胃、十二指肠和胰腺的病例，该病例表现为黑便和梗阻性黄疸。在十二指肠发现一个巨大的、出血性转移瘤。通过弹簧圈栓塞实现了止血。进行了内镜逆行胰胆管造影并对胆总管进行支架置入以缓解梗阻。对于发生远处转移的病例，应通过正电子发射断层扫描/计算机断层扫描进行密切监测，并可能进行胃肠道内镜检查，以识别和早期治疗胃肠道病变。
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