Arahata Kyoko, Takarabe Sakiko, Nakamura Kenji, Fujikawa Yasue, Katayama Tadashi, Ojiro Keisuke, Kishikawa Hiroshi, Sasaki Aya, Hasegawa Hirotoshi, Nishida Jiro
Department of Gastroenterology, Tokyo Dental College, Ichikawa General Hospital, 5-11-13, Sugano, Ichikawa, Chiba, 272-8513, Japan.
Department of Gastroenterology and Hepatology, Kyorin University School of Medicine, Tokyo, Japan.
Clin J Gastroenterol. 2025 Feb;18(1):62-66. doi: 10.1007/s12328-024-02065-z. Epub 2024 Nov 22.
We describe a case of gastric granular cell tumor (GCT) treated with laparoscopic and endoscopic cooperative surgery (LECS). A 30-year-old male was referred to our hospital for the investigation of a subepithelial lesion (SEL). Contrast-enhanced computed tomography and esophagogastroduodenoscopy revealed a 15 mm SEL within the posterior wall of the gastric body. Endoscopic ultrasound revealed a well-demarcated, homogenous, hypoechoic lesion in the submucosa, suggesting partial invasion into the muscularis propria. Biopsy using the bite-on-bite technique showed a gastric GCT diagnosis. The patient underwent LECS, and pathological findings confirmed a benign gastric GCT without muscularis propria invasion, lymphovascular invasion, or lymph node metastasis. The patient remained recurrence-free after 24 months.Despite unresolved issues such as setting the resection margins; indications for resection, and accurate preoperative diagnosis of the invasion depth, including muscularis propria invasion, LECS may be useful for gastric GCT in the form of SEL, especially for lesions that cannot be ruled out to invade the muscularis propria invasion.
我们描述了一例采用腹腔镜与内镜联合手术（LECS）治疗的胃颗粒细胞瘤（GCT）。一名30岁男性因上皮下病变（SEL）被转诊至我院。增强计算机断层扫描和食管胃十二指肠镜检查发现胃体后壁有一个15毫米的SEL。内镜超声显示黏膜下层有一个边界清晰、均匀、低回声的病变，提示部分侵犯固有肌层。采用咬取活检技术进行活检显示为胃GCT诊断。该患者接受了LECS，病理结果证实为良性胃GCT，无固有肌层侵犯、脉管侵犯或淋巴结转移。24个月后患者无复发。尽管存在诸如确定切除边缘、切除指征以及准确术前诊断包括固有肌层侵犯在内的浸润深度等尚未解决的问题，但LECS对于SEL形式的胃GCT可能是有用的，特别是对于不能排除侵犯固有肌层的病变。
