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腹腔镜-内镜联合治疗胃血管球瘤:1例报告

Combined laparoscopic-endoscopic approach for gastric glomus tumor: A case report.

作者信息

Wang Wen-Hao, Shen Ting-Ting, Gao Zhi-Xing, Zhang Xin, Zhai Zhao-Hui, Li Yu-Li

机构信息

Clinical Medical College, Weifang Medical University, Weifang 261042, Shandong Province, China.

Department of Gastroenterology, Affiliated Hospital of Weifang Medical University, Weifang 261042, Shandong Province, China.

出版信息

World J Clin Cases. 2021 Aug 26;9(24):7181-7188. doi: 10.12998/wjcc.v9.i24.7181.

Abstract

BACKGROUND

Gastric glomus tumor (GGT) is rare submucosal mesenchymal tumor that lacks specific clinical manifestations and is usually treated mainly by traditional surgical resection. This paper presents a case of a GGT, exhibited both intraluminally and extraluminally growth that was removed by laparoscopy-gastroscopy cooperative surgery.

CASE SUMMARY

A 52-year-old male presented with epigastric discomfort accompanied by a sense of fullness for 3 mo. Upper gastrointestinal endoscopy identified a submucosal lump located in the gastric antrum. Endoscopic ultrasonography identified a 2.4 cm × 1.8 cm lump located in the gastric antrum. It originated from the muscularis propria and exhibited both intraluminally and extraluminally growth, with hypoechoicity on the periphery, hyperechoicity in the middle, and unclear boundaries. Computed tomography showed nodular thickening of 3.0 cm × 2.2 cm in the gastric wall of the gastric antrum, and after enhancement, the lesion exhibited obvious enhancement We suspected that it was a gastrointestinal stromal tumor (glomus tumor and schwannoma were not excluded) and planned to perform laparoscopy-gastroscopy cooperative surgery. Immunohistochemical staining after the operation revealed that spinal muscular atrophy (+), h-caldesmon (+), cluster of differentiation 34 (CD34) (+), 2% Ki-67-positive rate, CD56, melanoma antigen, CD117, discovered on GIST-1, leukocyte common antigen, caudal type homeobox 2, cytokeratin, and S-100 were all negative. The tumor was finally diagnosed as a GGT.

CONCLUSION

GGTs are rare submucosal tumors of the stomach and should be considered in the differential diagnosis of gastric submucosal tumors. Laparoscopy-gastroscopy cooperative surgery is less invasive and more precise and could be an effective method for the treatment of GGTs.

摘要

背景

胃血管球瘤(GGT)是一种罕见的黏膜下间叶组织肿瘤,缺乏特异性临床表现,通常主要采用传统手术切除治疗。本文报道1例胃血管球瘤,该肿瘤呈腔内和腔外生长,通过腹腔镜-胃镜联合手术切除。

病例摘要

一名52岁男性,上腹部不适伴饱胀感3个月。上消化道内镜检查发现胃窦部有一黏膜下肿块。内镜超声检查发现胃窦部有一个2.4 cm×1.8 cm的肿块。它起源于固有肌层,呈腔内和腔外生长,周边低回声,中间高回声,边界不清。计算机断层扫描显示胃窦部胃壁有3.0 cm×2.2 cm的结节状增厚,增强后病变呈明显强化。我们怀疑它是胃肠道间质瘤(不排除血管球瘤和神经鞘瘤),计划行腹腔镜-胃镜联合手术。术后免疫组织化学染色显示脊髓性肌萎缩(+)、h-钙调蛋白(+)、分化簇34(CD34)(+)、Ki-67阳性率2%,CD56、黑色素瘤抗原、CD117、GIST-1、白细胞共同抗原、尾型同源框2、细胞角蛋白和S-100均为阴性。该肿瘤最终诊断为胃血管球瘤。

结论

胃血管球瘤是罕见的胃黏膜下肿瘤,在胃黏膜下肿瘤的鉴别诊断中应予以考虑。腹腔镜-胃镜联合手术创伤小、更精确,可能是治疗胃血管球瘤的有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f54/8409180/5411a95c98ee/WJCC-9-7181-g001.jpg

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