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胃大细胞神经内分泌癌根治术后孤立性异时性肾上腺转移:病例报告及文献复习。

Solitary metachronous adrenal metastasis after radical resection of gastric large cell neuroendocrine carcinoma: a case report and literature review.

机构信息

Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Science, Tongji Shanxi Hospital, Taiyuan, China.

出版信息

J Int Med Res. 2023 Apr;51(4):3000605231163709. doi: 10.1177/03000605231163709.

Abstract

Surgical resection is rarely employed for the treatment of metastatic gastric cancer, especially in patients with adrenal metastases, which usually indicate advanced systemic dissemination. Few published case reports have thus described the use of adrenalectomy for adrenal metastases from gastric cancer. In addition, most primary gastric malignancies are gastric adenocarcinomas, and gastric large cell neuroendocrine carcinoma (GLCNEC) is less common and has a poor prognosis. We report the case of a 71-year-old man who was diagnosed with solitary adrenal metastases 10 months after radical resection for GLCNEC and who was treated by adrenalectomy. He was followed-up for 9 months after adrenalectomy, with no further evidence of disease at his last follow-up examination. This case indicates that elective surgical resection may be feasible, even in rare cases of GLCNEC metastases to the adrenal glands, provided that the patient meets certain criteria, including solitary, metachronous tumors less than 4 cm.

摘要

手术切除很少用于治疗转移性胃癌,特别是对于肾上腺转移的患者,因为这通常意味着全身性疾病已经广泛扩散。因此,只有少数已发表的病例报告描述了使用肾上腺切除术治疗来自胃癌的肾上腺转移。此外,大多数原发性胃恶性肿瘤是胃腺癌,而胃大细胞神经内分泌癌(GLCNEC)则较为罕见,预后较差。我们报告了一例 71 岁男性患者,他在根治性切除 GLCNEC 10 个月后被诊断为孤立性肾上腺转移,并接受了肾上腺切除术。他在肾上腺切除术后进行了 9 个月的随访,最后一次随访检查时未发现疾病进一步进展。该病例表明,选择性手术切除可能是可行的,即使对于 GLCNEC 转移至肾上腺的罕见病例也是如此,前提是患者符合某些标准,包括孤立性、异时性、小于 4cm 的肿瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/477a/10084542/f475f1c8f774/10.1177_03000605231163709-fig1.jpg

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