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[青年弥漫性胃癌:病例报告]

[Diffuse gastric carcinoma in the youth: Case report].

作者信息

González-Aguirre Rodrigo, Sánchez-Moreno Héctor Ronaldo, Gutiérrez-Rodríguez Eulalio Alberto, Arce-Hernández Julio Alexis, Solis-Galindo Francisco Alfonso

机构信息

Instituto Mexicano del Seguro Social, Unidad Médica de Alta Especialidad No. 71, Servicio de Medicina Interna. Torreón, Coahuila, México.

Hospital Zambrano Hellion, Servicio de Medicina Interna. Monterrey, Nuevo León, México.

出版信息

Rev Med Inst Mex Seguro Soc. 2024 Jul 1;62(4):1-5. doi: 10.5281/zenodo.11397326.

Abstract

BACKGROUND

Gastric cancer is the 5th most common neoplasm in Mexico with an incidence of 13.6 per 100,000 inhabitants. In those under 35 years of age, it represents the 13th cause of cancer with an incidence of 0.37 per 100,000 inhabitants.

CLINICAL CASE

We present the case of a 21-year-old male patient treated at the High Specialty Medical Unit No. 71 of the Instituto Mexicano del Seguro Social in Torreón, Coahuila, Mexico. He started with burning epigastric pain lasting two months, which progressed with nausea, vomiting, hyporexia and weight loss of 10 kg in two months. Helicobacter pylori (+) in antigen in feces. Jaundice was added with a negative viral panel, laboratory tests with a cholestatic pattern. It was not possible to perform endoscopic cholangiopancreatography (ERCP) due to poor stomach compliance, with the presence of an atypical giant ulcer; the biopsy reported a neoplasm suggestive of diffuse adenocarcinoma. He was admitted for evaluation by interventional radiology for bile duct diversion. Immunohistochemistry (IMQ) reported diffuse gastric adenocarcinoma CD 45 (-), CK AE1 / AE3: (+) intense in neoplastic cells, HER 2 NEU (+). Treatment consisted of bile duct diversion, nasojejunal tube nutrition, and palliative treatment. The patient died one month after hospital admission.

CONCLUSION

The objective is to generate knowledge of the intentional search for the pathology to make timely diagnoses, in addition to reporting the atypical HER 2 NEU (+) presentation.

摘要

背景

胃癌是墨西哥第五大常见肿瘤,发病率为每10万居民中有13.6例。在35岁以下人群中,它是第13大致癌原因,发病率为每10万居民中有0.37例。

临床病例

我们介绍一例21岁男性患者,在墨西哥科阿韦拉州托雷翁市墨西哥社会保障局第71高级专科医疗单位接受治疗。他起初上腹部灼痛持续两个月,之后发展为恶心、呕吐、食欲减退,两个月内体重减轻10公斤。粪便抗原检测幽门螺杆菌(+)。出现黄疸,病毒检测结果为阴性,实验室检查呈胆汁淤积型。由于胃部顺应性差且存在非典型巨大溃疡,无法进行内镜逆行胰胆管造影(ERCP);活检报告提示为弥漫性腺癌。他因胆管改道接受介入放射学评估而入院。免疫组织化学(IMQ)报告为弥漫性胃腺癌,CD 45(-),CK AE1 / AE3:肿瘤细胞中呈强(+),HER 2 NEU(+)。治疗包括胆管改道、鼻空肠管营养和姑息治疗。患者入院一个月后死亡。

结论

目的是积累对该疾病的认识,以便有针对性地进行检查从而及时诊断,此外还报告了非典型HER 2 NEU(+)表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/50af/12367277/caefb91e689b/04435117-62-4-e5548-f001.jpg

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