Rivelli Matteo, Fernandes Eduardo, Conti Cristian, Bernardoni Laura, Pecori Sara, Cingarlini Sara, Pedrazzani Corrado
Unit of General and Hepatobiliary Surgery, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Verona University, Verona, Italy.
Division of Minimally Invasive, General and Robotic Surgery, University of Illinois at Chicago, Chicago, USA.
World J Surg Oncol. 2021 Mar 1;19(1):65. doi: 10.1186/s12957-021-02172-y.
Synovial sarcoma (SS) is a rare soft tissue tumor. Among different anatomical locations where it can be found, gastric localization is a very uncommon one. Based on soft tissue sarcoma guidelines, complete tumor excision is considered the main treatment approach. Depending on size and localization of the tumor, both wedge and major gastric resections have been performed in the past for the treatment of this condition.
We present the case of a 43-year-old woman who underwent a laparoscopic intragastric excision of a gastric 10-mm SS located nearby the esophagogastric junction. Pathology examination confirmed the presence of a SS. The resected specimen confirmed margin-free excision of a monophasic spindle cell neoplasm invading the submucosa and presenting the rearrangement of SS18 gene at fluorescence in situ hybridization (FISH). No adjuvant treatment was offered, and 18 months after surgery, the patient was alive and disease free.
This represents the first case reported in literature of a laparoscopic intragastric resection for a gastric SS. This approach allowed to obtain a full thickness radical tumor resection with the advantages of minimally invasive and organ preserving surgery.
滑膜肉瘤（SS）是一种罕见的软组织肿瘤。在其可发生的不同解剖部位中，胃部定位非常少见。根据软组织肉瘤治疗指南，完整切除肿瘤被视为主要治疗方法。过去，根据肿瘤的大小和定位，楔形切除和胃大部切除术都曾用于治疗这种疾病。
我们报告一例43岁女性患者，她接受了腹腔镜下胃内切除位于食管胃交界处附近的10毫米胃部滑膜肉瘤。病理检查证实为滑膜肉瘤。切除标本证实为单相梭形细胞瘤的无瘤边缘切除，该肿瘤侵犯黏膜下层，荧光原位杂交（FISH）显示存在SS18基因重排。未给予辅助治疗，术后18个月，患者存活且无疾病。
这是文献中报道的首例腹腔镜下胃内切除胃部滑膜肉瘤的病例。这种方法能够实现全层根治性肿瘤切除，具有微创和保留器官手术的优点。
