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胃原发性孤立性纤维性肿瘤:一例报告并文献复习

Primary solitary fibrous tumor of the stomach: A case report and a review of literature.

作者信息

Dong Ling-Yun, Li Ying-Chun, Tong Hai-Chao, Guo Yao-Xing, Li Le-Yao, Zhang Wan-Lin, Ma Shuang, Yang Lian-He, Petersen Philip, Wang Endi

机构信息

Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences, China Medical University, Shenyang, Liaoning, China.

Department of Pathology, Yangzhou Maternal and Child Health Hospital, Yangzhou, Jiangsu, China.

出版信息

Medicine (Baltimore). 2025 Jan 10;104(2):e41096. doi: 10.1097/MD.0000000000041096.

Abstract

RATIONALE

Solitary fibrous tumors (SFTs) are spindle cell tumors that typically occur in the pleura and peritoneum, but very rarely in the stomach. To our best knowledge, there are only 10 cases reported in English literature. We reported a case of primary stomach SFT and summarized the characteristics of all previous cases, suggesting that pathologists and surgeons should include this disease in the differential diagnosis list of primary mesenchymal tumor of the stomach.

PATIENT CONCERNS

The patient suffered from epigastric pain for 5 months. Gastroscopy revealed a submucosa mass along the greater curvature centered on the gastric body. A repeat gastroscopy after 6 months showed a slight increase in mass size.

DIAGNOSES

Endoscopic ultrasound showed the mass in the middle and lower portion of the stomach body, measuring 3.1cm in diameter, with a smooth surface. The patient was initially diagnosed with a gastrointestinal stromal tumor by gastroscopy. However, the pathologic morphology and immunohistochemical staining of resected specimens after surgery support a diagnosis of primary gastric SFT.

INTERVENTIONS

The patient underwent a laparoscopic gastric mass resection.

OUTCOMES

The patient returned to hospital after 3 months with no recurrence or postoperative complications. During the 18-month follow-up period, the patient did not experience any tumor recurrence or metastasis.

LESSONS

This case teaches us that SFT should be included in the differential diagnoses of gastric primary spindle cell tumors, even though it is very rare in the stomach.

摘要

理论依据

孤立性纤维瘤(SFTs)是一种梭形细胞瘤,通常发生于胸膜和腹膜,但极少发生于胃部。据我们所知,英文文献中仅报道过10例。我们报告了1例原发性胃SFT病例,并总结了既往所有病例的特征,提示病理学家和外科医生应将该疾病纳入胃原发性间叶性肿瘤的鉴别诊断清单。

患者情况

患者上腹部疼痛5个月。胃镜检查发现胃体部大弯侧有一个以胃体为中心的黏膜下肿块。6个月后复查胃镜显示肿块大小略有增加。

诊断

超声内镜显示胃体中下部有一肿块,直径3.1cm,表面光滑。患者最初经胃镜诊断为胃肠道间质瘤。然而,手术后切除标本的病理形态学和免疫组化染色支持原发性胃SFT的诊断。

干预措施

患者接受了腹腔镜下胃肿块切除术。

结果

患者3个月后返院,无复发及术后并发症。在18个月的随访期内,患者未出现任何肿瘤复发或转移。

经验教训

该病例告诉我们,尽管SFT在胃部非常罕见,但在胃原发性梭形细胞瘤的鉴别诊断中应将其纳入。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1158/11730670/3c3bc522708b/medi-104-e41096-g001.jpg

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