Department of Surgery, Creighton University School of Medicine, Phoenix, AZ, USA.
Am Surg. 2023 Jul;89(7):3289-3291. doi: 10.1177/00031348231160825. Epub 2023 Feb 28.
Gastrointestinal stromal tumors (GISTs) are connective tissue tumors representing a minority of gastrointestinal tumors. A 49-year-old woman was found to have a rectal mass in addition to uterine fibroids during work-up for abnormal uterine bleeding. A peri-rectal mass was again seen during hysterectomy, but definitive resection was deferred. A pelvic MRI suggested a posterior vaginal wall mass. A transvaginal approach was chosen for excision of a solid multi-lobulated mass from the rectovaginal septum space. Frozen section reported uterine leiomyoma, but final pathology confirmed a 10-cm high-risk GIST arising from the rectal muscularis propria, with microscopically positive margins. Patient was started on imatinib therapy. Abdominopelvic resection was offered to decrease the risk of recurrence but was declined. Repeat imaging has shown no obvious distant metastases or residual rectovaginal region mass. The simultaneous and similar presentation of uterine leiomyoma and rectal GIST draws attention to this case.
胃肠道间质瘤（GISTs）是结缔组织肿瘤，占胃肠道肿瘤的少数。一名 49 岁妇女在因异常子宫出血进行检查时除了子宫肌瘤外还发现直肠肿块。在子宫切除术中再次发现直肠周围肿块，但未进行明确切除。盆腔 MRI 提示阴道后壁肿块。选择经阴道入路从直肠阴道隔腔切除实性多叶肿块。冷冻切片报告为子宫肌瘤，但最终病理证实为来源于直肠固有肌层的 10cm 高危 GIST，边缘显微镜下阳性。患者开始接受伊马替尼治疗。提供了腹部盆腔切除术以降低复发风险，但被拒绝。重复影像学检查未显示明显远处转移或直肠阴道区域残留肿块。子宫肌瘤和直肠 GIST 的同时相似表现引起了对该病例的关注。
