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胃血管球瘤:病例报告及文献复习。

Gastric glomus tumor: a case report and review of the literature.

机构信息

Department of General Surgery, Venizeleio General Hospital, Leoforos Knossou 44, 71409, Heraklion, Crete, Greece.

Department of Pathology, Venizeleio General Hospital, Leoforos Knossou 44, Heraklion, Crete, Greece.

出版信息

J Med Case Rep. 2021 Aug 16;15(1):415. doi: 10.1186/s13256-021-03011-0.

Abstract

INTRODUCTION

Gastric glomus tumor is a rare mesenchymal neoplasm. There are only a few cases of the tumor showing malignancy, and there are no specific guidelines for the management of this entity.

CASE PRESENTATION

We present the case of a 53-year-old Caucasian male who was hospitalized for anemia. Computerized tomography of the abdomen depicted a mass between the pylorus of the stomach and the first part of the duodenum. Preoperative diagnosis was achieved with pathology examination of the biopsies taken via endoscopic ultrasound and upper gastrointestinal endoscopy. An antrectomy with Roux-en-Y anastomosis and appendicectomy, due to suspicion of appendiceal mucocele, were performed. The patient had an uneventful postoperative recovery and was discharged 5 days later.

DISCUSSION

Preoperative diagnosis of a gastric glomus tumor is difficult owing to the location of the tumor and the lack of specific clinical and endoscopic characteristics. Furthermore, it is exceptional to establish diagnosis with biopsies taken through endoscopic ultrasound or upper gastrointestinal endoscopy, prior to surgical resection. Although most glomus tumors are benign and are not known to metastasize, there are rare examples of glomus tumors exhibiting malignancy. Treatment of choice is considered wide local excision with negative margins. However, long-term follow-up is required as there is the possibility of malignancy.

CONCLUSION

The aim of this report is to enlighten doctors about this uncommon pathologic entity. Surgical resection is considered the golden standard therapy to establish a diagnosis and evaluate the malignant potential.

摘要

简介

胃血管球瘤是一种罕见的间叶性肿瘤。仅有少数肿瘤表现为恶性,对于这种病变尚无特定的治疗指南。

病例介绍

我们报告了 1 例 53 岁白人男性患者,因贫血住院。腹部计算机断层扫描显示胃幽门和十二指肠第一段之间有一肿块。通过内镜超声和上消化道内镜活检进行病理检查以明确术前诊断。因怀疑阑尾黏液囊肿,行胃大部切除术和 Roux-en-Y 吻合术及阑尾切除术。患者术后恢复顺利,5 天后出院。

讨论

由于肿瘤位置和缺乏特定的临床及内镜特征,胃血管球瘤的术前诊断较为困难。此外,在手术切除前,通过内镜超声或上消化道内镜活检来确诊较为罕见。虽然大多数血管球瘤是良性的,且不会转移,但也有罕见的血管球瘤表现为恶性。首选治疗方法被认为是广泛局部切除并保证切缘阴性。然而,由于存在恶性的可能,需要长期随访。

结论

本报告旨在让医生了解这种不常见的病理实体。手术切除被认为是建立诊断和评估恶性潜能的金标准治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bba6/8365960/a29a979b7beb/13256_2021_3011_Fig1_HTML.jpg

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