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同时患有胰腺神经鞘瘤的胃癌:一例报告。

Gastric cancer with concurrent pancreatic schwannoma: A case report.

作者信息

Ribeiro Mateus Barradas, Abe Emerson Shigueaki, Kondo André, Safatle-Ribeiro Adriana Vaz, Pereira Marina Alessandra, Zilberstein Bruno, Ribeiro Ulysses

机构信息

Department of Gastroenterology, Instituto do Cancer, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Sao Paulo 01249000, Brazil.

出版信息

World J Gastrointest Pathophysiol. 2022 May 22;13(3):107-113. doi: 10.4291/wjgp.v13.i3.107.

Abstract

BACKGROUND

The differential diagnosis of abdominal masses is somewhat troublesome, especially when there is a malignancy to be evaluated. We report herein a unique case of gastric adenocarcinoma concurrent with a pancreatic schwannoma. Correct assessment of intraoperative findings is essential for adequate tumor staging and to decide the proper management of a concurrent pancreatic lesion.

CASE SUMMARY

Computed tomography scan performed for gastric cancer staging revealed a solid and cystic pancreatic mass that had no signs of local invasiveness. Surgical resection of the pancreas was decided preoperatively since a radical approach of the gastric tumor could be performed. There were no signs of distant metastases, and the large pancreatic mass was in contact with the posterior gastric wall. Histopathological study revealed a pancreatic schwannoma, which is an uncommon neoplasm that arises from Schwann cells around peripheral nerves.

CONCLUSION

Therefore, pancreatic masses deserve special attention regarding the differential diagnosis in patients with gastric cancer. The presence of a large pancreatic mass should not preclude the potentially curative intent of the gastric cancer treatment.

摘要

背景

腹部肿块的鉴别诊断有些棘手,尤其是在需要评估是否存在恶性肿瘤时。我们在此报告一例胃腺癌并发胰腺神经鞘瘤的独特病例。正确评估术中发现对于准确的肿瘤分期以及决定对并发胰腺病变的恰当处理至关重要。

病例摘要

为评估胃癌分期而进行的计算机断层扫描显示胰腺有一个实性和囊性肿块,无局部侵袭迹象。由于可以对胃肿瘤采取根治性手术,术前决定对胰腺进行手术切除。没有远处转移的迹象,且较大的胰腺肿块与胃后壁相连。组织病理学研究显示为胰腺神经鞘瘤,这是一种起源于周围神经施万细胞的罕见肿瘤。

结论

因此,对于胃癌患者的胰腺肿块鉴别诊断应给予特别关注。存在较大的胰腺肿块不应排除胃癌治疗潜在的治愈意图。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57f7/9157687/945ab4c5d6bb/WJGP-13-107-g001.jpg

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