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术前精确诊断后经内镜黏膜下剥离术完全切除胃平滑肌肉瘤

Gastric Leiomyosarcoma Completely Resected by Endoscopic Submucosal Dissection after a Precise Preoperative Diagnosis.

作者信息

Yachi Kazuma, Hatta Waku, Koike Tomoyuki, Kayada Kimiko, Tanno Naotaro, Ogata Yohei, Saito Masahiro, Jin Xiaoyi, Uno Kaname, Asano Naoki, Imatani Akira, Watanabe Hirofumi, Fujishima Fumiyoshi, Masamune Atsushi

机构信息

Division of Gastroenterology, Tohoku University Graduate School of Medicine, Japan.

Department of Pathology, Tohoku University Hospital, Japan.

出版信息

Intern Med. 2025 Mar 1;64(5):705-709. doi: 10.2169/internalmedicine.3645-24. Epub 2024 Aug 1.

DOI:10.2169/internalmedicine.3645-24
PMID:39085073
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11949666/
Abstract

A 68-year-old woman was diagnosed with leiomyosarcoma (LMS) based on preoperative biopsy of the gastric body. As tumor invasion confined to the submucosa with no breaking of the submucosal layer was confirmed on endoscopic ultrasonography (EUS), the patient underwent endoscopic submucosal dissection (ESD) for gastric LMS, resulting in complete tumor resection. No apparent recurrence was observed in the 2.5 years after treatment. This is an extremely rare case of gastric LMS that underwent ESD after a precise preoperative diagnosis, with no signs of recurrence after treatment. ESD may be an acceptable option for gastric LMS when EUS findings allow this treatment method.

摘要

一名68岁女性经胃体部术前活检被诊断为平滑肌肉瘤（LMS）。由于内镜超声检查（EUS）确认肿瘤侵犯局限于黏膜下层且黏膜下层未被突破，该患者接受了胃LMS的内镜黏膜下剥离术（ESD），肿瘤得以完全切除。治疗后2.5年内未观察到明显复发。这是一例极为罕见的胃LMS病例，在进行精确的术前诊断后接受了ESD治疗，治疗后无复发迹象。当EUS检查结果允许采用这种治疗方法时，ESD可能是胃LMS的一种可接受的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dd5/11949666/4caa6c02f4d4/1349-7235-64-0705-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dd5/11949666/5e25f11665bf/1349-7235-64-0705-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dd5/11949666/dcda36339f62/1349-7235-64-0705-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dd5/11949666/2749cca3a688/1349-7235-64-0705-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dd5/11949666/4a7097bea236/1349-7235-64-0705-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dd5/11949666/4caa6c02f4d4/1349-7235-64-0705-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dd5/11949666/5e25f11665bf/1349-7235-64-0705-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dd5/11949666/dcda36339f62/1349-7235-64-0705-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dd5/11949666/2749cca3a688/1349-7235-64-0705-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dd5/11949666/4a7097bea236/1349-7235-64-0705-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6dd5/11949666/4caa6c02f4d4/1349-7235-64-0705-g005.jpg

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本文引用的文献

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Endoscopic management of subepithelial lesions including neuroendocrine neoplasms: European Society of Gastrointestinal Endoscopy (ESGE) Guideline.包括神经内分泌肿瘤在内的上皮下病变的内镜管理：欧洲胃肠内镜学会（ESGE）指南
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Gastrointestinal leiomyosarcoma demonstrate a predilection for distant recurrence and poor response to systemic treatments.
胃肠道平滑肌肉瘤倾向于远处复发，对全身治疗反应不佳。
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Leiomyosarcoma of the stomach treated by endoscopic submucosal dissection.经内镜黏膜下剥离术治疗的胃平滑肌肉瘤
Clin J Gastroenterol. 2018 Aug;11(4):291-296. doi: 10.1007/s12328-018-0838-4. Epub 2018 Mar 2.
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Laparoscopic and luminal endoscopic cooperative surgery can be a standard treatment for submucosal tumors of the stomach: a retrospective multicenter study.腹腔镜与腔内内镜联合手术可作为胃黏膜下肿瘤的标准治疗方法：一项回顾性多中心研究
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Histopathology. 2013 Aug;63(2):194-207. doi: 10.1111/his.12159. Epub 2013 Jun 13.
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Primary gastric leiomyosarcoma in young revealed by a massive hematemesis.因大量呕血而发现的青年原发性胃平滑肌肉瘤。
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