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同步性胃肠道间质瘤(GIST)合并胰腺腺癌:一例报告。

Synchronous Gastrointestinal Stromal Tumor (GIST) with pancreatic adenocarcinoma: A case report.

作者信息

A/L Chandrasekaran Terukumar, Sahid Nik Amin, Maiyauen Thanesh Kumar

机构信息

Surgical Department, Hospital Queen Elizabeth, 13a, Jalan Penampang, 88200, Kota Kinabalu, Sabah, Malaysia.

Surgical Department, Faculty of Medicine & Health Sciences, University Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia.

出版信息

Ann Med Surg (Lond). 2022 Apr 11;77:103588. doi: 10.1016/j.amsu.2022.103588. eCollection 2022 May.

DOI:10.1016/j.amsu.2022.103588
PMID:35638052
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9142392/
Abstract

INTRODUCTION

Gastrointestinal Stromal Tumors (GIST) are rare mesenchymal neoplasm of gastrointestinal tract. Stomach is the most common site affected by GIST compared to other places in gastrointestinal track. The coexistence of GIST with another malignancy represents a rare phenomenon with few literature reported.

CASE PRESENTATION

We present here 65 years old patient with stomach GIST and synchronous pancreatic adenocarcionoma discovered during surgery for suspected pancreatic mucinious cystadenoma. Distal pancreaticosplenectomy with excision of GIST Tumor & wedge resection of stomach was done. Histopathological examination of resected specimens reported the margins are clear.

DISCUSSION

In this article we discuss on the option of systemic therapy versus upfront surgery and their outcome benefit based on literature review.

CONCLUSION

The coexistence of GIST with pancreatic adenocarcinoma is a rare condition. High clinical analysis needed during laparotomy for GIST to detect a synchronous tumor. In a case of GIST the surgeon should recognize the possibility of another tumor with different histological origin. Surgical excision is the mainstay of therapy and it has proven to be curative for our patient. . Due to its rare occurrence and limited literature further studies has to be done on GIST with other synchronous tumor to help the surgeon to manage the patient optimally.

摘要

引言

胃肠道间质瘤(GIST)是胃肠道罕见的间叶性肿瘤。与胃肠道其他部位相比,胃是受GIST影响最常见的部位。GIST与另一种恶性肿瘤并存是一种罕见现象,相关文献报道较少。

病例介绍

我们在此介绍一位65岁的患者,在因疑似胰腺黏液性囊腺瘤进行手术时发现患有胃GIST和同步性胰腺腺癌。进行了远端胰腺脾切除术,切除GIST肿瘤并对胃进行楔形切除术。切除标本的组织病理学检查报告切缘清晰。

讨论

在本文中,我们基于文献综述讨论了全身治疗与 upfront手术的选择及其疗效益处。

结论

GIST与胰腺腺癌并存是一种罕见情况。在对GIST进行剖腹手术期间需要进行高度临床分析以检测同步性肿瘤。对于GIST病例,外科医生应认识到存在另一种具有不同组织学起源肿瘤的可能性。手术切除是主要治疗方法,并且已证明对我们的患者具有治愈性。由于其罕见性和文献有限,必须对GIST与其他同步性肿瘤进行进一步研究以帮助外科医生最佳地管理患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cff2/9142392/1dc632736290/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cff2/9142392/de677b93693e/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cff2/9142392/e5f561cc2f36/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cff2/9142392/1dc632736290/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cff2/9142392/de677b93693e/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cff2/9142392/e5f561cc2f36/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cff2/9142392/1dc632736290/gr3.jpg

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本文引用的文献

1
The SCARE 2020 Guideline: Updating Consensus Surgical CAse REport (SCARE) Guidelines.SCARE 2020 指南:更新共识手术病例报告(SCARE)指南。
Int J Surg. 2020 Dec;84:226-230. doi: 10.1016/j.ijsu.2020.10.034. Epub 2020 Nov 9.
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Pancreatic adenocarcinoma.胰腺腺癌
N Engl J Med. 2014 Sep 11;371(11):1039-49. doi: 10.1056/NEJMra1404198.
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Occurrence of other tumors in patients with GIST.GIST 患者中的其他肿瘤发生情况。
Surg Oncol. 2010 Dec;19(4):e140-3. doi: 10.1016/j.suronc.2010.06.004. Epub 2010 Aug 2.