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直肠颗粒细胞瘤需行腹会阴联合切除术。

Rectal Granular Cell Carcinoma Requiring Abdominoperineal Resection.

机构信息

Department of Surgery, University of South Florida, Tampa, FL, USA.

出版信息

Am Surg. 2023 Apr;89(4):1304-1306. doi: 10.1177/0003134821989047. Epub 2021 Mar 20.

Abstract

BACKGROUND

Granular cell tumors, derived from neural crest cells, are rare tumors infrequently located in the colon or rectum. We will discuss a patient with a rectal granular cell tumor invading the anal sphincters requiring an abdominoperineal resection.

METHODS

A 56-year-old male, with anal pain, was found to have a perirectal mass. Pathology from ultrasound-guided transrectal biopsy demonstrated low grade granular cell tumor. The patient underwent a laparoscopic abdominoperineal resection with perineum reconstruction.

RESULTS

Pathology demonstrated a granular cell tumor of 4.5 centimeters with tumor invasion of the anal sphincters. Surgical margins were free of neoplasm.

DISCUSSION

This is the only documented case of a colorectal granular cell tumor that has required an abdominoperineal resection. On histology, it was considered low grade but its behavior was more consistent with a malignant process. Additional research on malignant granular cell tumors is necessary to help improve treatment options, prevent recurrence, and improve overall survival. His medical course will be followed for disease progression or metastasis.

摘要

背景

颗粒细胞瘤来源于神经嵴细胞,是一种罕见的肿瘤,通常位于结肠或直肠。我们将讨论一位患有侵犯肛门括约肌的直肠颗粒细胞瘤的患者,需要进行腹会阴联合切除术。

方法

一位 56 岁男性,出现肛门疼痛,直肠超声检查发现直肠周围肿块。经直肠超声引导下的活检显示为低度恶性颗粒细胞瘤。患者接受了腹腔镜下腹会阴联合切除术和会阴重建。

结果

病理显示肿瘤大小为 4.5 厘米,侵犯肛门括约肌。手术切缘无肿瘤残留。

讨论

这是唯一有记录的需要进行腹会阴联合切除术的结直肠颗粒细胞瘤病例。组织学上,该肿瘤被认为是低度恶性的,但它的行为更符合恶性过程。需要进一步研究恶性颗粒细胞瘤,以帮助改善治疗选择、预防复发和提高总体生存率。将对他的医疗过程进行随访,以观察疾病进展或转移情况。

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