Department of Gastroenterological Surgery, Chiba Cancer Center, 666-2 Nitonacho, Chuo‑ku, Chiba, 260‑8717, Japan.
Department of General Surgery, Chiba University Graduate School of Medicine, Chiba, Japan.
Clin J Gastroenterol. 2021 Oct;14(5):1386-1391. doi: 10.1007/s12328-021-01483-7. Epub 2021 Jul 21.
Undifferentiated pleomorphic sarcoma (UPS) in the gastrointestinal tract is rare. According to the diagnostic criteria after the World Health Organization 2013 reclassification, there has been only one case of UPS with perforation of the gastrointestinal tract. A 71-year-old man who was undergoing outpatient chemotherapy at the department of respiratory medicine of our hospital for lung cancer and brain metastasis, was admitted to our hospital with sudden high fever and abdominal pain. A computed tomography scan showed free air in the abdominal cavity with thickening of part of the jejunal wall. We suspected jejunal metastasis of lung cancer and performed emergency surgery for acute peritonitis due to gastrointestinal perforation in the same area. A Bormann type 2 tumour was found in the jejunum with perforation. The histopathological diagnosis was UPS. Ten months have passed since the surgery, and there has been no recurrence of UPS and no significant change in lung cancer. Primary UPS of the gastrointestinal tract is rare, and cases with perforation are extremely rare. Currently, ten months have passed since the surgery, and no recurrence has been observed. We encountered a case of UPS in which it was difficult to distinguish metastasis from lung cancer to the jejunum, and the emergency surgery gave us the chance to confirm the definitive diagnosis and save the patient's life.
胃肠道未分化多形性肉瘤（UPS）较为罕见。根据 2013 年世界卫生组织重新分类的诊断标准，仅有一例 UPS 并发胃肠道穿孔。一位 71 岁的男性因肺癌和脑转移在我院呼吸内科接受门诊化疗，因突发高热和腹痛入院。计算机断层扫描显示腹腔内有游离气体，部分空肠壁增厚。我们考虑肺癌空肠转移，并因同一部位胃肠道穿孔导致急性腹膜炎行急诊手术。空肠发现 Bormann 2 型肿瘤，病理诊断为 UPS。手术后 10 个月，UPS 无复发，肺癌无明显变化。胃肠道原发性 UPS 罕见，穿孔病例更为罕见。目前，手术后 10 个月，未观察到复发。我们遇到了一例 UPS 病例，难以区分空肠转移是来自肺癌还是 UPS，急诊手术为我们提供了明确诊断和挽救患者生命的机会。
