Xu Jian-Duo, Wang Zheng, Zhou Qian, Meng Ning, Zhang Shu-Mei, Liu Nan
Department of Gastrointestinal Surgery, Shijiazhuang People's Hospital, Shijiazhuang 050000, Hebei Province, China.
Department of Gastroenterology, Shijiazhuang People's Hospital, Shijiazhuang 050000, Hebei Province, China.
World J Clin Cases. 2024 Sep 16;12(26):5990-5997. doi: 10.12998/wjcc.v12.i26.5990.
Extragastrointestinal stromal tumors (EGIST) and gastrointestinal stromal tumors are of similar pathological type and form. Here we report a rare case of EGIST diffusely distributed in membranous tissue in abdominal cavity, the feature of which included diffuse tumors at membranous tissue in entire abdominal cavity and spontaneous bleeding of the tumors.
The patient was a 71-year man and hospitalized due to continuous pain at lower abdomen for more than 10 days. Upon physical examination, the patient had flat and tough abdomen with mild pressing pain at lower abdomen, no obvious abdominal mass was touchable, and shifting dullness was positive. Positron emission tomography-computed tomography (CT) showed that in his peritoneal cavity, there were multiple nodules of various sizes, seroperitoneum, multiple enlarged lymph nodes in abdominal/pelvic cavity and right external ilium as well as pulmonary nodules. Plain CT scanning at epigastrium/hypogastrium/pelvic cavity + enhanced three-dimensional reconstruction revealed multiple soft tissue nodules in abdominal/pelvic cavity, peritoneum and right groin. Tumor marker of carbohydrate antigen 125 was 808 U/mL, diffuse tuberous tumor was seen in abdominal/pelvic cavity during operation with hematocelia, and postoperative pathological examination confirmed EGIST. Imatinib was administered with better therapeutic effect.
Gene testing showed and genovariation, and the patient was treated with imatinib follow-up visit found that his clinical symptoms disappeared and the tumor load alleviated obviously imageological examination.
胃肠道外间质瘤(EGIST)与胃肠道间质瘤具有相似的病理类型和形态。在此,我们报告1例罕见的EGIST病例,其在腹腔膜性组织中呈弥漫性分布,特点为整个腹腔膜性组织出现弥漫性肿瘤且肿瘤自发出血。
患者为71岁男性,因下腹部持续疼痛10余天入院。体格检查时,患者腹部平坦且质地硬,下腹部有轻度压痛,未触及明显腹部肿块,移动性浊音阳性。正电子发射断层扫描-计算机断层扫描(CT)显示其腹腔内有多个大小不一的结节、腹腔积液、腹盆腔及右髂外多个肿大淋巴结以及肺部结节。上腹部/下腹部/盆腔CT平扫+增强三维重建显示腹盆腔、腹膜及右腹股沟有多个软组织结节。糖类抗原125肿瘤标志物为808 U/mL,术中见腹盆腔弥漫性结节状肿瘤伴腹腔积血,术后病理检查确诊为EGIST。给予伊马替尼治疗,疗效较好。
基因检测显示 和 基因变异,患者接受伊马替尼治疗,随访发现其临床症状消失,肿瘤负荷经影像学检查明显减轻。