Colorectal Surgery, Cleveland Clinic Main Campus Hospital, Cleveland, Ohio, USA
Colorectal Surgery, Cleveland Clinic Main Campus Hospital, Cleveland, Ohio, USA.
BMJ Case Rep. 2022 Mar 14;15(3):e248505. doi: 10.1136/bcr-2021-248505.
A man in his 70s presented with narrowing of his stool calibre and a palpable mass on rectal examination. Colonoscopy revealed a submucosal bulge without a mucosal lesion. CT and MRI demonstrated an 8×5.4×7 cm mass in lower rectum. Biopsy of the mass confirmed a rectal gastrointestinal stromal tumour (GIST). It was moderately sensitive to neoadjuvant imatinib and radiotherapy, which slightly downsized the tumour. He required abdominal perineal resection with curative intent. Uncommonly found in the rectum, when located here, GISTs are typically aggressive and are a rare cause of stool calibre narrowing. Rectal GISTs should be considered in patients presenting with this symptom.
一位 70 多岁的男性患者出现粪便变细和直肠指检可触及肿块。结肠镜检查显示黏膜下隆起,无黏膜病变。CT 和 MRI 显示直肠下段有一个 8×5.4×7 cm 的肿块。肿块活检证实为直肠胃肠道间质瘤(GIST)。它对新辅助伊马替尼和放疗中度敏感,使肿瘤略有缩小。他需要进行有治愈意图的腹会阴联合切除术。直肠 GIST 不常见,当位于此处时,通常具有侵袭性,是导致粪便变细的罕见原因。当患者出现这种症状时,应考虑直肠 GIST。