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胃副神经节瘤:一例病例报告及文献综述

Gastric paraganglioma: a case report and review of literature.

作者信息

Hu Chengyu, Luo Bixian, Hong Bo, Zhang Mingqi, Wu Zelai, Zhu Xiuliang, Luan Fengming, Huang Yi, Gong Weihua

机构信息

Department of Surgery, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.

Department of Pathology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.

出版信息

Front Oncol. 2024 Apr 2;14:1357612. doi: 10.3389/fonc.2024.1357612. eCollection 2024.

Abstract

Paragangliomas (PGLs) are rare neuroendocrine tumors which overproduce catecholamines (CAs). They are extra-adrenal, catecholamine-secreting tumors occurring outside the adrenal glands. Gastric PGLs originating from extra-adrenal paraganglia are exceptionally rare, and their presentation in geriatric patients further adds to the complexity of diagnosis and management. A 72-year-old male patient presented with enduring left upper abdominal pain and anemia persisting for over a year, and hypertension for six months. Physical examination revealed epigastric discomfort and pallor. Computed tomography scans revealed enlarged lymph nodes in the lesser curvature of the stomach and thickening of the gastric antrum wall with concavity. The patient underwent three cycles of neoadjuvant therapy before radical gastrectomy for gastric cancer. These imaging findings were confirmed during surgery and intraoperative blood pressure was in fluctuation. After the successful resection of the tumor, postoperative pathology confirmed paraganglioma. During postoperative examination, it was observed that the patient's CAs and their metabolites had returned to within the normal range. Combined with the existing ten literatures, we retrospective report the clinical and pathological characteristics and treatment strategies of the rare gastric paraganglioma.

摘要

副神经节瘤(PGLs)是一种罕见的神经内分泌肿瘤,可过量分泌儿茶酚胺(CAs)。它们是发生在肾上腺外的、分泌儿茶酚胺的肿瘤。起源于肾上腺外副神经节的胃PGLs极为罕见,其在老年患者中的表现进一步增加了诊断和管理的复杂性。一名72岁男性患者出现左上腹持续性疼痛和贫血,持续一年多,并有六个月的高血压病史。体格检查发现上腹部不适和面色苍白。计算机断层扫描显示胃小弯处淋巴结肿大,胃窦壁增厚且呈凹陷状。该患者在接受胃癌根治性胃切除术之前接受了三个周期的新辅助治疗。这些影像学表现在手术中得到证实,术中血压波动。肿瘤成功切除后,术后病理证实为副神经节瘤。术后检查发现患者的儿茶酚胺及其代谢产物已恢复到正常范围内。结合现有的十篇文献,我们回顾性报告了罕见胃副神经节瘤患者的临床病理特征及治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3068/11018878/8c5cc0f06eca/fonc-14-1357612-g001.jpg

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