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巨大胃肠道外肠系膜间质瘤：一例报告及罕见非特异性症状实体的文献综述

Giant Extragastrointestinal Mesenteric Stromal Tumor: A Case Report and Literature Review of a Rare Entity With Nonspecific Symptoms.

作者信息

Medina-Muñoz Dario E, Morales-Ramírez Roberto, Treviño-Arizmendi César J, Pacheco-Molina Carlos, Vásquez-Fernádez Francisco, Navarro-Bahena Eduardo, Treviño-Lozano Marco A, Muñoz-Maldonado Gerardo E, Girón-Cuestas Rodrigo H, Barbosa-Quintana Alvaro

机构信息

General Surgery, Dr. José Eleuterio González University Hospital at the Autonomous University of Nuevo León, Monterrey, MEX.

Pathology and Laboratory Medicine, Dr. José Eleuterio González University Hospital at the Autonomous University of Nuevo León, Monterrey, MEX.

出版信息

Cureus. 2025 Jan 28;17(1):e78135. doi: 10.7759/cureus.78135. eCollection 2025 Jan.

DOI:10.7759/cureus.78135
PMID:40026962
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11867770/
Abstract

Extragastrointestinal stromal tumors (EGISTs) are rare mesenchymal neoplasms with a low frequency compared to gastrointestinal stromal tumors (GISTs). EGISTs share histological and immunohistochemical features with GISTs but occur outside the gastrointestinal tract, commonly in the mesentery or omentum. We report the case of a 52-year-old male presenting with a large asymptomatic abdominal mass. Imaging revealed a semi-solid-cystic tumor measuring 22 x 14 x 21.8 cm. Exploratory laparotomy confirmed an EGIST originating in the mesentery, which was successfully resected without complications. Histopathology showed high mitotic activity, positivity, and areas of necrosis. Postoperative recovery was uneventful, and the patient remains under follow-up. To the best of our knowledge, this case represents the first documented EGIST at José Eleuterio González University Hospital and one of the largest reported in Mexico. EGISTs remain poorly understood, and early surgical intervention remains the cornerstone of treatment. Further research is essential to develop tailored guidelines for their management.

摘要

胃肠道外间质瘤（EGISTs）是一种罕见的间叶性肿瘤，与胃肠道间质瘤（GISTs）相比发病率较低。EGISTs与GISTs具有相同的组织学和免疫组化特征，但发生于胃肠道外，常见于肠系膜或网膜。我们报告一例52岁男性患者，表现为腹部有一巨大无症状肿块。影像学检查发现一个大小为22×14×21.8 cm的半实性囊性肿瘤。剖腹探查证实为起源于肠系膜的EGIST，手术成功切除，无并发症。组织病理学显示有高有丝分裂活性、阳性表现及坏死区域。术后恢复顺利，患者仍在随访中。据我们所知，该病例是何塞·埃莱乌特里奥·冈萨雷斯大学医院首例有记录的EGIST，也是墨西哥报道的最大病例之一。EGISTs仍未被充分了解，早期手术干预仍然是治疗的基石。开展针对其管理的定制指南的进一步研究至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0217/11867770/97b629106843/cureus-0017-00000078135-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0217/11867770/d5402032109e/cureus-0017-00000078135-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0217/11867770/bf18786bcecb/cureus-0017-00000078135-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0217/11867770/93db1bc6a35e/cureus-0017-00000078135-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0217/11867770/a67f13179f2b/cureus-0017-00000078135-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0217/11867770/97b629106843/cureus-0017-00000078135-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0217/11867770/d5402032109e/cureus-0017-00000078135-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0217/11867770/bf18786bcecb/cureus-0017-00000078135-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0217/11867770/93db1bc6a35e/cureus-0017-00000078135-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0217/11867770/a67f13179f2b/cureus-0017-00000078135-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0217/11867770/97b629106843/cureus-0017-00000078135-i05.jpg

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本文引用的文献

1
Primary extra-gastrointestinal stromal tumor (EGIST) of the mesentery: Case report and review of literature.肠系膜原发性胃肠道外间质瘤（EGIST）：病例报告及文献复习
Ann Med Surg (Lond). 2020 Nov 11;60:480-483. doi: 10.1016/j.amsu.2020.11.020. eCollection 2020 Dec.
2
Extragastrointestinal stromal tumour (EGIST) presented as a mesenteric and retroperitoneal mass.胃肠道外间质瘤（EGIST）表现为肠系膜和腹膜后肿块。
BMJ Case Rep. 2019 Dec 2;12(12):e232481. doi: 10.1136/bcr-2019-232481.
3
Gastrointestinal stromal tumors: a comprehensive review.
胃肠道间质瘤：全面综述
J Gastrointest Oncol. 2019 Feb;10(1):144-154. doi: 10.21037/jgo.2018.08.20.
4
Extragastrointestinal Stromal Tumor (EGIST): A 16-Year Experience of 13 Cases Diagnosed at a Single Center.胃肠道外间质瘤（EGIST）：单中心 13 例 16 年诊治经验。
Med Sci Monit. 2018 May 19;24:3301-3306. doi: 10.12659/MSM.907654.
5
Global epidemiology of gastrointestinal stromal tumours (GIST): A systematic review of population-based cohort studies.胃肠道间质瘤（GIST）的全球流行病学：基于人群队列研究的系统评价
Cancer Epidemiol. 2016 Feb;40:39-46. doi: 10.1016/j.canep.2015.10.031. Epub 2015 Nov 24.
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Pathologic complete response with neoadjuvant imatinib for locally advanced pelvic GIST.新辅助伊马替尼治疗局部晚期骨盆 GIST 的病理完全缓解。
Int J Clin Oncol. 2011 Jun;16(3):279-83. doi: 10.1007/s10147-010-0133-y. Epub 2010 Oct 5.
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Extragastrointestinal (soft tissue) stromal tumors: an analysis of 48 cases with emphasis on histologic predictors of outcome.胃肠道外（软组织）间质瘤：48例病例分析，重点关注预后的组织学预测指标。
Mod Pathol. 2000 May;13(5):577-85. doi: 10.1038/modpathol.3880099.