Nudotor Richard, Ali Abdel-Moneim M, Weltz Adam, Park Adrian, Gibson Glen
Surgery, Anne Arundel Medical Center, Annapolis, USA.
Cureus. 2024 Apr 27;16(4):e59159. doi: 10.7759/cureus.59159. eCollection 2024 Apr.
Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors accounting for only a small fraction of all primary malignant tumors of the gastrointestinal tract. Histologically, GISTs are classified as epithelioid, spindle type, or mixed. We present a case of a 66-year-old male incidentally noted to have a pedunculated gastric mass along the lesser curvature of the stomach during a laparoscopic Nissen fundoplication and hiatal hernia repair. A wedge resection was performed and the pathology demonstrated a 3.7 cm GIST of epithelioid type. Four years after the initial surgery, a jejunal mass was identified via CT enterography as part of a workup for ongoing iron deficiency anemia. A laparoscopic small bowel resection was performed, and the pathology revealed a new primary 3.2 cm GIST of the spindle cell subtype. Three years after surgery, surveillance imaging is negative for any recurrence. This appears to be the first report of the occurrence of metachronous primary GISTs of different histologic subtypes, separated by location.
胃肠道间质瘤（GISTs）是间叶性肿瘤，仅占胃肠道所有原发性恶性肿瘤的一小部分。从组织学上看，GISTs分为上皮样型、梭形细胞型或混合型。我们报告一例66岁男性病例，该患者在腹腔镜尼氏胃底折叠术和食管裂孔疝修补术中偶然发现胃小弯处有一个带蒂的胃肿物。进行了楔形切除术，病理显示为3.7 cm上皮样型GIST。初次手术后四年，通过CT小肠造影发现空肠肿物，作为对持续性缺铁性贫血进行检查的一部分。进行了腹腔镜小肠切除术，病理显示为新的原发性3.2 cm梭形细胞亚型GIST。手术后三年，监测影像未发现任何复发迹象。这似乎是首例关于不同组织学亚型的异时性原发性GISTs在不同部位发生的报告。
