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[以肠套叠诊断的小肠平滑肌肉瘤——病例报告]

[Small Intestinal Leiomyosarcoma Diagnosed with Intussusception-A Case Report].

作者信息

Yamada Atsushi, Sakamoto Shota, Imai Minoru, Nakagawa Tomo, Toyama Kazutaka, Toguchi Keisuke, Yoshikawa Kenji, Yamaguchi Takuya

机构信息

Dept. of Surgery, Mimihara General Hospital.

出版信息

Gan To Kagaku Ryoho. 2024 Dec;51(13):1818-1820.

Abstract

A 87-year-old man presented to our hospital with intermittent abdominal pain. We diagnosed intussusception of the small intestine by CT and performed laparoscopic-assisted partial resection of the small intestine. It was diagnosed as small intestine leiomyosarcoma by pathological examination and the operation was curative. Leiomyosarcoma is rare among small intestinal tumors, and since 1999, when immunostaining was used to define small intestinal leiomyosarcoma, there have been only 15 confirmed cases in Japan, including our own case. Of the 15 cases, 5 died within an average of about 17 months, making it a disease with a poor prognosis. On the other hand, considering that there are multiple cases that have maintained recurrence-free survival with only local resection without lymph node dissection, and that non-surgical reduction is less effective in cases involving neoplastic small bowel intussusception, we believe that performing early local resection using minimally invasive laparoscopy is effective.

摘要

一名87岁男性因间歇性腹痛前来我院就诊。我们通过CT诊断为小肠套叠,并进行了腹腔镜辅助小肠部分切除术。病理检查诊断为小肠平滑肌肉瘤,手术为根治性手术。平滑肌肉瘤在小肠肿瘤中较为罕见,自1999年采用免疫染色定义小肠平滑肌肉瘤以来,包括我们自己的病例在内,日本仅有15例确诊病例。在这15例病例中,5例平均在约17个月内死亡,这是一种预后较差的疾病。另一方面,考虑到有多个病例仅通过局部切除且未进行淋巴结清扫就维持了无复发生存,并且在涉及肿瘤性小肠套叠的病例中非手术复位效果较差,我们认为使用微创腹腔镜进行早期局部切除是有效的。

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