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内镜辅助腹腔镜下胃血管球瘤楔形切除术:一例报告

Endoscopy-assisted laparoscopic wedge-resection of gastric glomus tumor: A case report.

作者信息

Cláudio Jozyel Castro, Filizzola Paulo Antonio Martins, Figueiredo Higino Felipe, Lira Daniel Lourenço, da Costa Aline Pereira, Cardoso Tiago Magalhães

机构信息

Department of General Surgery of Samel Hospital, M Street, 110c, Compensa, 69030-360 Manaus, Brazil.

School of Medicine of Federal University of Amazonas, Afonso Pena Street, 1053, Centro, 69020-160 Manaus, Brazil.

出版信息

Int J Surg Case Rep. 2024 Sep;122:110100. doi: 10.1016/j.ijscr.2024.110100. Epub 2024 Aug 3.

Abstract

INTRODUCTION

Glomus tumor is a pericytic mesenchymal neoplasm that most commonly occurs in the extremities. The occurrence in visceral organs is rare and is a differential diagnosis with other gastric submucosal tumors.

PRESENTATION OF CASE

A woman with epigastric pain underwent esophagogastroduodenoscopy (EGD) which revealed a gastric submucosal tumor. Endoscopic ultrasound with fine-needle aspiration allowed preoperative diagnosis of gastric glomus tumor. Intraoperative EGD-assisted laparoscopic segmental gastrectomy was successfully performed. The patient was discharged in the second postoperative day. There was no evidence of recurrence at 8 months of follow-up.

DISCUSSION

The stomach is a rare location for the glomus tumor, a neoplasm of the glomus body, which is a perivascular structure with thermoregulatory function. Preoperative diagnosis is challenging, and endoscopic ultrasound (EUS) is useful for both assessing malignancy-associated features and biopsy guiding. The treatment is surgical resection with attention to adequate oncological margins while preserving healthy gastric wall.

CONCLUSION

Immunohistochemical analysis of specimen obtained by EUS fine-needle allows accurate preoperative diagnosis and laparoscopic-endoscopic combined surgery allows good oncological and functional results.

摘要

引言

血管球瘤是一种周细胞间叶性肿瘤,最常发生于四肢。发生于内脏器官的情况罕见,且需与其他胃黏膜下肿瘤进行鉴别诊断。

病例介绍

一名患有上腹部疼痛的女性接受了食管胃十二指肠镜检查(EGD),结果显示有一个胃黏膜下肿瘤。内镜超声引导下细针穿刺活检实现了胃血管球瘤的术前诊断。术中在EGD辅助下成功实施了腹腔镜节段性胃切除术。患者术后第二天出院。随访8个月时无复发迹象。

讨论

胃是血管球瘤的罕见发病部位,血管球瘤是血管球的一种肿瘤,血管球是具有温度调节功能的血管周围结构。术前诊断具有挑战性,内镜超声(EUS)对于评估恶性相关特征和活检引导均有用。治疗方法是手术切除,在保留健康胃壁的同时注意获得足够的肿瘤学切缘。

结论

EUS细针获取标本的免疫组化分析可实现准确的术前诊断,腹腔镜 - 内镜联合手术可取得良好的肿瘤学和功能效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f98c/11345927/049d8228460c/gr1.jpg

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