Shrestha Bibek Man, Shrestha Suraj, Kharel Sanjeev, Adhikari Shankar, Tiwari Sansar Babu, Kandel Bishnu Prasad, Lakhey Paleswan Joshi
Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal.
Maharajgunj Medical Campus, Institute of Medicine, Kathmandu, Nepal.
Int J Surg Case Rep. 2021 Jul;84:106097. doi: 10.1016/j.ijscr.2021.106097. Epub 2021 Jun 8.
Cecal gastrointestinal stromal tumors (GIST) constitute a rarer subtype of all GISTs. Rarely, it can present with ileocolic intussusception in adults making it a challenging diagnosis due to non-specific clinical features.
A 30-year previously healthy woman presented with lower abdominal pain and a distended abdomen who was subsequently diagnosed with ileocolic intussusception on a CT scan. Intraoperatively, a pedunculated polypoid hard mass was identified in the cecum and thus, a standard right hemicolectomy was performed with the suspicion of malignancy. Histopathology of the resected mass confirmed CD117 negative, spindle type GIST.
Cecal GIST presenting in the form of ileocolic intussusception is rare. Contrast-enhanced CT scan is the preferred imaging modality for the evaluation of patients with suspected GIST to determine the extent of the tumor, the presence or absence of metastatic disease alongside evaluation of the possibility of complete resection. Adjuvant imatinib therapy following complete resection decreases the disease recurrence.
Intussusception in an adult can be the first manifestation of underlying malignancy like GIST. Complete surgical resection of the tumor with a negative margin offers long-term survival.
盲肠胃肠道间质瘤(GIST)是所有GIST中较罕见的一种亚型。在成人中,它很少表现为回结肠套叠,由于临床特征不具特异性,使其诊断颇具挑战性。
一名30岁既往健康的女性因下腹痛和腹部膨隆就诊,随后CT扫描诊断为回结肠套叠。术中,在盲肠发现一个有蒂的息肉样硬块,因此,怀疑为恶性肿瘤而行标准的右半结肠切除术。切除肿块的组织病理学检查确诊为CD117阴性的梭形GIST。
以回结肠套叠形式出现的盲肠GIST较为罕见。增强CT扫描是评估疑似GIST患者的首选影像学检查方法,以确定肿瘤范围、有无转移疾病,并评估能否完整切除。完整切除后辅助使用伊马替尼治疗可降低疾病复发率。
成人肠套叠可能是像GIST这样的潜在恶性肿瘤的首发表现。肿瘤切缘阴性的完整手术切除可带来长期生存。