Sato Manabu, Sato Masayuki, Yokoyama Tadaaki, Kusaka Akiko, Suzuki Yukie, Fukuhara Kenji
Department of Surgery, Shiogama City Hospital, Shiogama, Miyagi, Japan.
J Surg Case Rep. 2022 Jun 16;2022(6):rjac246. doi: 10.1093/jscr/rjac246. eCollection 2022 Jun.
We performed the accurate diagnosis and complete surgical resection of a gastrointestinal stromal tumor at the mesentery of the small bowel. Computed tomography (CT) in a 62-year-old man at 2 years after gastrectomy for gastric cancer showed a mesenteric tumor, with no other tumors noted. Positron emission tomography-computed tomography (PET-CT) showed a maximum standardized uptake value (SUV max) of 2.9 at the tumor. The presence of a single and low SUV max tumor allowed us to perform laparoscopic surgery. Partial resection of the tumor with an adequate margin was performed. The pathological findings showed c-kit positivity and a low Ki-67 proliferation index (<5%). In the present case, PET-CT and laparoscopic assessments were useful for accurately evaluating the surgical resectability of the mesenteric tumor after distal gastrectomy for gastric cancer. The low SUV max and laparoscopic findings led to complete surgical resection of a mesenteric tumor.
我们对一名小肠系膜的胃肠道间质瘤进行了准确诊断并完整切除。一名62岁男性在胃癌胃切除术后2年的计算机断层扫描(CT)显示有一个肠系膜肿瘤,未发现其他肿瘤。正电子发射断层扫描-计算机断层扫描(PET-CT)显示肿瘤处的最大标准化摄取值(SUV max)为2.9。单个且SUV max值较低的肿瘤使我们能够进行腹腔镜手术。我们对肿瘤进行了带足够切缘的部分切除。病理结果显示c-kit阳性且Ki-67增殖指数较低(<5%)。在本病例中,PET-CT和腹腔镜评估有助于准确评估胃癌远端胃切除术后肠系膜肿瘤的手术可切除性。SUV max值较低以及腹腔镜检查结果使得肠系膜肿瘤得以完整切除。