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恶性十二指肠胃肠道神经外胚层肿瘤(GNET):病例报告及文献复习

Malignant duodenal gastrointestinal neuroectodermal tumor (GNET): Case report and review of the literature.

作者信息

Fournier Antony, Deslauriers Vicki, Giguère Charlie Champagne, Borduas Martin, Collin Yves

机构信息

Department of Surgery, University of Sherbrooke, Sherbrooke, Canada.

Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Canada.

出版信息

Int J Surg Case Rep. 2024 Oct;123:110195. doi: 10.1016/j.ijscr.2024.110195. Epub 2024 Aug 20.

Abstract

INTRODUCTION

Malignant gastrointestinal neuroectodermal tumor (GNET) is a rare malignancy primarily affecting the gastrointestinal tract. Upon cross-sectional imaging, it can be easily confused with other mesenchymal tumors. This article presents a case of duodenal GNET and reviews the current literature on this rare entity.

PRESENTATION OF CASE

A 73-year-old female patient presented with a 4 cm duodenal mass on CT scan. With a presumptive diagnosis of GIST, a D3-D4 duodenectomy with cholecystectomy were performed. Subsequent pathological analysis of the surgical specimen revealed a 4.5 cm malignant gastrointestinal neuroectodermal tumor (GNET), also known as clear cell sarcoma-like gastrointestinal tumor (CCSLGT).

DISCUSSION

While there are less than 115 cases of GNET reported worldwide, prognosis is usually poor with a 50 % survival at 3 years, and mortality rate described is as high as 75 %. To the authors' knowledge, this duodenal GNET case represents the first one ever described for this location.

CONCLUSION

Early recognition of GNET is essential due to its poor prognosis and its ability to metastasize. Awareness of its existence and diagnostic criteria by every member of the medical team is key to obtain optimal patient care.

摘要

引言

恶性胃肠道神经外胚层肿瘤(GNET)是一种罕见的恶性肿瘤,主要累及胃肠道。在横断面成像上,它很容易与其他间叶组织肿瘤混淆。本文介绍了一例十二指肠GNET病例,并回顾了关于这一罕见实体的当前文献。

病例介绍

一名73岁女性患者在CT扫描中发现十二指肠有一个4厘米的肿块。初步诊断为胃肠道间质瘤(GIST),遂行D3-D4十二指肠切除术及胆囊切除术。手术标本的后续病理分析显示为一个4.5厘米的恶性胃肠道神经外胚层肿瘤(GNET),也称为透明细胞肉瘤样胃肠道肿瘤(CCSLGT)。

讨论

虽然全球报道的GNET病例不到115例,但预后通常较差,3年生存率为50%,死亡率高达75%。据作者所知,该十二指肠GNET病例是该部位首例报道。

结论

由于GNET预后不良且具有转移能力,早期识别至关重要。医疗团队的每一位成员都意识到其存在和诊断标准是获得最佳患者护理的关键。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3770/11408805/4ef7195b2bf8/gr1.jpg

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