Gupta Rahul, Gusain Deepak, Bansal Nalini, Varshney Rahul, Singh Arvind
Gastrointestinal Surgery, Synergy Institute of Medical Sciences, Dehradun, IND.
Pathology, SGT (Shree Guru Gobind Singh Tricentenary) University, Gurugram, IND.
Cureus. 2024 Feb 20;16(2):e54507. doi: 10.7759/cureus.54507. eCollection 2024 Feb.
Metastatic gastrointestinal neuroendocrine tumors classically appear as contrast-enhancing lesions on computed tomography. However, in a small percentage of patients, these lesions can be cystic in nature, leading to false diagnoses of benign or infectious lesions such as echinococcosis. Hence, every cystic lesion of the liver must be carefully investigated before making the treatment plan. We report a patient with hematemesis caused by a large gastric ulcer with multiple cystic lesions in the left lobe of the liver abutting the stomach. The liver lesions were misdiagnosed as hepatic echinococcosis, and the patient was started on medical therapy. However, when medical therapy failed, the patient underwent surgical excision and the histopathology showed cystic metastases of a gastric neuroendocrine tumor.
转移性胃肠道神经内分泌肿瘤在计算机断层扫描上通常表现为强化病灶。然而,在一小部分患者中,这些病灶本质上可能是囊性的,从而导致对良性或感染性病变(如棘球蚴病)的误诊。因此,在制定治疗方案之前,必须对肝脏的每一个囊性病变进行仔细检查。我们报告了一名因巨大胃溃疡导致呕血的患者,其肝脏左叶有多个囊性病变,与胃相邻。肝脏病变被误诊为肝棘球蚴病,患者开始接受药物治疗。然而,当药物治疗失败后,患者接受了手术切除,组织病理学显示为胃神经内分泌肿瘤的囊性转移。