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一例疑似转移性胃肠道间质瘤合并中间型链球菌化脓性肝病的罕见病例。

An Unusual Case of Suspected Metastatic Gastrointestinal Stromal Tumor Complicated by Streptococcus Intermedius Pyogenic Liver Disease.

作者信息

Louis-Jean Scarlet F, Sabakhtarishvili Giorgi, Damota Amanda, Tavadze Maia

机构信息

Medicine, Anne Arundel Medical Center, Annapolis, USA.

Internal Medicine, Anne Arundel Medical Center, Annapolis, USA.

出版信息

Cureus. 2023 Jan 30;15(1):e34397. doi: 10.7759/cureus.34397. eCollection 2023 Jan.

Abstract

A gastrointestinal stromal tumor (GIST) is a mesenchymal neoplasm of the gastrointestinal tract often known to express c-KIT or platelet-derived growth factor receptor alpha (PDGFRα). Among all GI tract cancers, they account for less than 1% of cases. Most patients become symptomatic in the later stages of the tumor's course, often presenting with insidious anemia due to gastrointestinal bleeding and metastasis. The recommended management of solitary GIST is surgery, while larger or metastatic tumors that express c-KIT are managed with imatinib as either neoadjuvant or adjuvant therapy. Due to the progression of these tumors, they are at times associated with systemic anaerobic infection, which is an indication of malignancy workup. In this case report, we discuss a 35-year-old woman who was discovered to have GIST with possible hepatic metastasis complicated by pyogenic liver disease due to S and the diagnostic challenge of differentiating between infection and tumor.

摘要

胃肠道间质瘤(GIST)是一种胃肠道间叶肿瘤,通常已知其表达c-KIT或血小板衍生生长因子受体α(PDGFRα)。在所有胃肠道癌症中,它们占病例不到1%。大多数患者在肿瘤病程后期出现症状,常因胃肠道出血和转移而出现隐匿性贫血。孤立性GIST的推荐治疗方法是手术,而表达c-KIT的较大或转移性肿瘤则用伊马替尼作为新辅助或辅助治疗。由于这些肿瘤的进展,它们有时与全身性厌氧菌感染有关,这是恶性肿瘤检查的一个指征。在本病例报告中,我们讨论了一名35岁女性,她被发现患有GIST并可能伴有肝转移,因S菌并发化脓性肝病以及区分感染和肿瘤的诊断挑战。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d6b/9977106/166ea7e396bd/cureus-0015-00000034397-i01.jpg

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