Takahashi Ayano, Inada Kentaro, Kitani Yusuke, Koseki Takayoshi, Maeshiro Tsuyoshi
Department of Gastrointestinal Surgery, Saitama Prefectural Cancer Center, Saitama, JPN.
Department of Surgery, Tokyo Metropolitan Bokutoh Hospital, Tokyo, JPN.
Cureus. 2024 May 23;16(5):e60897. doi: 10.7759/cureus.60897. eCollection 2024 May.
Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors that arise in the muscular or submucosal layers of the gastrointestinal tract. Extra-gastrointestinal stromal tumors (EGISTs) are rare primary entities that develop outside the digestive tract which are histologically and immunologically similar to GISTs. We present the case of a 52-year-old female diagnosed with a primary EGIST arising in the small bowel mesentery four months after undergoing hormone therapy for multiple uterine myomas. Transvaginal ultrasonography and MRI revealed a pelvic mass suspected to be a GIST. The patient was treated with laparoscopic-assisted partial resection of the small bowel. Histopathological examination of the surgical specimen confirmed the diagnosis of an EGIST. Imatinib treatment was initiated, and no clinical evidence of recurrence or metastasis was detected postoperatively. Because EGISTs are extremely rare, the differences between EGISTs and GISTs, the degree of malignancy, and prognosis have not been fully investigated. Further studies are needed to accumulate additional cases. The present case shows that laparoscopic-assisted excision can be successfully used to manage EGISTs.
胃肠道间质瘤(GISTs)是起源于胃肠道肌层或黏膜下层的间叶性肿瘤。胃肠道外间质瘤(EGISTs)是罕见的原发肿瘤,发生于消化道外,在组织学和免疫学上与GISTs相似。我们报告一例52岁女性病例,该患者在接受多发性子宫肌瘤激素治疗4个月后,被诊断为起源于小肠系膜的原发性EGIST。经阴道超声检查和磁共振成像显示盆腔肿块,怀疑为GIST。患者接受了腹腔镜辅助小肠部分切除术。手术标本的组织病理学检查确诊为EGIST。开始使用伊马替尼治疗,术后未发现复发或转移的临床证据。由于EGISTs极为罕见,EGISTs与GISTs之间的差异、恶性程度及预后尚未得到充分研究。需要进一步开展研究以积累更多病例。本病例表明,腹腔镜辅助切除术可成功用于治疗EGISTs。