Department of Surgery, Chiba-Ken Saiseikai Narashino Hospital, Social Welfare Organization, Saiseikai Imperial Gift Foundation, 1-Chome-1-1 Izumi-cho, Narashino city, Chiba, 275-8580, Japan.
Department of Gastroenterology, Chiba-Ken Saiseikai Narashino Hospital, Social Welfare Organization, Saiseikai Imperial Gift Foundation, 1-Chome-1-1 Izumi-cho, Narashino city, Chiba, 275-8580, Japan.
Clin J Gastroenterol. 2022 Dec;15(6):1055-1060. doi: 10.1007/s12328-022-01708-3. Epub 2022 Oct 3.
Collision tumors composed of adenocarcinoma and gastrointestinal stromal tumor (GIST) of the stomach are extremely uncommon, and only a few cases have been reported in the English literature. In the present case, a 67-year-old woman visited a local hospital for vomiting and hematemesis. An esophagogastroduodenoscopy study indicated an elevated lesion with ulceration. Histology of the endoscopic biopsy specimen indicated gastric adenocarcinoma. The patient underwent laparoscopic distal gastrectomy with D2 lymph node dissection. The resected specimen showed that the primary tumor consisted of a GIST and that early-stage gastric carcinoma coexisted in the mucosa surrounding the central ulceration of the GIST. Although close contact of the adenocarcinoma and GIST was observed on the mucosal surface, no intermixing of tumor cells was observed in the primary tumor. This case is an extremely rare case of a collision tumor composed of early-stage gastric adenocarcinoma and GIST occurring in the stomach, which provides some insight into a better understanding of the pathogenesis of collision tumors.
胃的腺癌和胃肠道间质瘤(GIST)构成的碰撞瘤极为罕见,仅在英文文献中有少数报道。在本病例中,一位 67 岁女性因呕吐和呕血到当地医院就诊。食管胃十二指肠镜检查显示有一处隆起伴溃疡。内镜活检标本的组织学检查提示胃腺癌。患者接受了腹腔镜下远端胃切除术和 D2 淋巴结清扫术。切除标本显示原发性肿瘤由 GIST 组成,在 GIST 中央溃疡周围的黏膜中并存早期胃癌。虽然在黏膜表面观察到腺癌和 GIST 紧密接触,但在原发性肿瘤中未观察到肿瘤细胞的混合。本例是胃中早期胃癌和 GIST 构成的罕见碰撞瘤病例,为更好地理解碰撞瘤的发病机制提供了一些见解。