Zhong Ziyou, Li Zhenguo, Xing Yufeng, Guo Shaoju
The Fourth Clinical Medical College, Guangzhou University of Chinese Medicine, Shenzhen, Guangdong, China.
Department of Gastroenterology, Shenzhen Traditional Chinese Medicine Hospital, Shenzhen, Guangdong, China.
Front Oncol. 2024 Aug 12;14:1385695. doi: 10.3389/fonc.2024.1385695. eCollection 2024.
Gastric calcifying fibrous tumor (CFT) is a rare benign mesenchymal tumor. Several previous studies have reported surgical resection for gastric CFT larger than 20mm for the difficulty in preoperative diagnosis. Here, we report a rare case of large gastric CFT treated with endoscopic submucosal excavation (ESE). A 70-year-old woman presented with recurrent epigastric pain and underwent endoscopy, which revealed a 35mm-sized submucosal tumor in the gastric body. ESE was performed after imaging examination and endoscopic ultrasonography. En bloc resection was achieved, but due to the specimen's substantial size and difficulty in mincing, it posed challenges for removal through the mouth. Finally, the specimen was temporarily placed in the stomach and was completely removed two days later. The diagnosis was confirmed based on pathological and immunohistochemical findings. There was no recurrence during the patient's 11-month follow-up. We provided a case report related to the diagnosis and endoscopic treatment for large gastric CFT. In addition, our experience of temporarily leaving a large postoperative specimen, considered a benign lesion, in the stomach for later removal was successful but requires appropriate timing to avoid blockage of the gastrointestinal tract.
胃钙化性纤维性肿瘤（CFT）是一种罕见的良性间叶组织肿瘤。此前有多项研究报道，由于术前诊断困难，对于直径大于20mm的胃CFT需进行手术切除。在此，我们报告一例采用内镜下黏膜下剥离术（ESE）治疗的巨大胃CFT罕见病例。一名70岁女性因反复上腹部疼痛接受内镜检查，发现胃体部有一个35mm大小的黏膜下肿瘤。在进行影像学检查和内镜超声检查后实施了ESE。实现了整块切除，但由于标本体积较大且难以切碎，经口腔取出存在挑战。最后，标本被暂时置于胃内，两天后被完整取出。根据病理和免疫组化结果确诊。患者在11个月的随访期间未出现复发。我们提供了一例关于巨大胃CFT诊断和内镜治疗的病例报告。此外，我们将被认为是良性病变的术后大标本暂时留在胃内以便后续取出的经验是成功的，但需要把握合适时机以避免胃肠道梗阻。
