Asada Yuya, Kuroda Kohei, Shirasaka Daisuke, Era Yukiko, Ikegawa Takuya, Arai Yu, Nakahara Akiko, Kawano Miki, Kadowaki Yoshihiko, Okino Takeshi
Department of Gastroenterology and Hepatology, Kobe Red Cross Hospital.
Department of Surgery, Kobe Red Cross Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2022;119(10):946-953. doi: 10.11405/nisshoshi.119.946.
A 53-year-old woman who had undergone excision of KIT-positive extra-gastrointestinal stromal tumor (EGIST) of the vulva 6 years ago presented to our hospital due to a positive fecal occult blood test. Colonoscopy revealed a submucosal tumor in the rectum ventral side. In addition, computed tomography and magnetic resonance imaging revealed a tumor in the rectovaginal septum. For diagnostic and therapeutic purposes, the tumor was resected via the perineal approach. The resected specimen analysis revealed a KIT-positive gastrointestinal stromal tumor (GIST). Following immunopathological and genetic mutation identifications, GIST of the rectovaginal septum from vulva EGIST metastasis was diagnosed. It is important to consider primary GIST and metastatic GIST as differential diagnoses in the case of a rectal submucosal tumor detected by endoscopy.
一名53岁女性，6年前接受了外阴KIT阳性的胃肠道外间质瘤（EGIST）切除术，因粪便潜血试验阳性前来我院就诊。结肠镜检查发现直肠腹侧有一个黏膜下肿瘤。此外，计算机断层扫描和磁共振成像显示直肠阴道隔有一个肿瘤。为了诊断和治疗，通过会阴途径切除了肿瘤。切除标本分析显示为KIT阳性的胃肠道间质瘤（GIST）。经过免疫病理和基因突变鉴定，诊断为外阴EGIST转移至直肠阴道隔的GIST。在内镜检查发现直肠黏膜下肿瘤的情况下，将原发性GIST和转移性GIST作为鉴别诊断很重要。
