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成功内镜切除一异增大且带蒂的Ⅰ型胃类癌肿瘤。

Successful endoscopic resection of an unusually enlarged and pedunculated type I gastric carcinoid tumour.

机构信息

Department of Surgery, Detroit Medical Center, Detroit, Michigan, USA

Department of Pathology, Detroit Medical Center, Detroit, Michigan, USA.

出版信息

BMJ Case Rep. 2021 Aug 19;14(8):e244292. doi: 10.1136/bcr-2021-244292.

Abstract

Three distinct gastric carcinoid (GC) tumour types have been described based on differing biological behaviour and prognoses. Type I GC tumours account for the vast majority (70%-80%), are associated with chronic atrophic gastritis and have a low metastatic potential. Type II carcinoid tumours are the least common (5%-10%), are related to Zollinger-Ellison syndrome and occur in relation to multiple neoplasia type I. Sporadic type III tumours (15%-25%) are the most aggressive type, are unrelated to gastrin over secretion and carry the worst prognosis. In this case report, we present a patient with longstanding gastroesophageal reflux disease (GERD) who presented with epigastric abdominal pain and tarry stools and was found to have a large gastric polyp on endoscopy. Despite current literature recommending surgical resection for larger GC tumours, endoscopic resection was successfully used to excise the tumour with pathology demonstrating complete resection with negative margins.

摘要

根据不同的生物学行为和预后,已经描述了三种不同的胃类癌(GC)肿瘤类型。I 型 GC 肿瘤占绝大多数(70%-80%),与慢性萎缩性胃炎相关,转移潜能低。II 型类癌肿瘤是最不常见的(5%-10%),与 Zollinger-Ellison 综合征相关,发生于多发性 I 型肿瘤。散发性 III 型肿瘤(15%-25%)侵袭性最强,与胃泌素过度分泌无关,预后最差。在本病例报告中,我们介绍了一位患有长期胃食管反流病(GERD)的患者,他出现上腹痛和柏油样便,并在内镜检查中发现一个大的胃息肉。尽管目前的文献建议对较大的 GC 肿瘤进行手术切除,但内镜下切除成功地切除了肿瘤,病理检查显示完全切除且边缘阴性。

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