Wang Jing-Jie, Zhang Fen-Ming, Chen Wei, Zhu Hua-Tuo, Gui Ning-Long, Li Ai-Qing, Chen Hong-Tan
Department of Gastroenterology, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, Zhejiang Province, China.
World J Gastrointest Surg. 2024 Jul 27;16(7):2351-2357. doi: 10.4240/wjgs.v16.i7.2351.
Extragastric lesions are typically not misdiagnosed as gastric submucosal tumor (SMT). However, we encountered two rare cases where extrinsic lesions were misdiagnosed as gastric SMTs.
We describe two cases of gastric SMT-like protrusions initially misdiagnosed as gastric SMTs by the abdominal contrast-enhanced computed tomography (CT) and endoscopic ultrasound (EUS). Based on the CT and EUS findings, the patients underwent gastroscopy; however, no tumor was identified after incising the gastric wall. Subsequent surgical exploration revealed no gastric lesions in both patients, but a mass was found in the left triangular ligament of the liver. The patients underwent laparoscopic tumor resection, and the postoperative diagnosis was hepatic hemangiomas.
During EUS procedures, scanning across different layers and at varying degrees of gastric cavity distension, coupled with meticulous image analysis, has the potential to mitigate the likelihood of such misdiagnoses.
胃外病变通常不会被误诊为胃黏膜下肿瘤(SMT)。然而,我们遇到了两例罕见病例,其中外在病变被误诊为胃SMT。
我们描述了两例最初经腹部增强计算机断层扫描(CT)和内镜超声(EUS)误诊为胃SMT的胃SMT样突出病例。根据CT和EUS检查结果,患者接受了胃镜检查;然而,切开胃壁后未发现肿瘤。随后的手术探查显示两名患者均无胃部病变,但在肝左三角韧带处发现了一个肿块。患者接受了腹腔镜肿瘤切除术,术后诊断为肝血管瘤。
在EUS检查过程中,跨不同层次并在不同程度的胃腔扩张状态下进行扫描,再加上细致的图像分析,有可能降低此类误诊的可能性。