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Gastrointestinal Stromal Tumor of the Stomach with an Abscess Excised by Laparoscopic Surgery

机译:腹腔镜手术切除脓肿的胃胃肠道间质瘤

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摘要

Gastrointestinal stromal tumors (GISTs) of the stomach presenting as an intra-abdominal abscess are extremely rare. We herein report a case that underwent successful laparoscopic resection of gastric GIST presenting with an intra-abdominal abscess. A 70-year-old man presented with a 3-day history of acute upper abdominal pain with a fever. Laboratory data showed an elevated white blood cell count and C-reactive protein level. A CT scan revealed a mass of mixed solid and fluid components, measuring 5.5 cm, in the adjacent lesser curvature of the stomach. He was diagnosed as having an intra-abdominal abscess, and antibiotic therapy was administered. Consequently, his symptoms were relieved and a CT scan on the 7th day showed that the mass reduced and became homogenous. According to the results of a fine-needle aspiration biopsy, the tumor was suspected to be a GIST. Laparoscopic surgery with the 5-port approach was performed. The tumor existed in the lesser curvature of the stomach, and was excised en bloc with the omentum and gastric wall by wedge resection. The tumor measured 3.0 cm in diameter and originated from the serosal layer of the stomach. Histological findings showed spindle cells with a stromal growth pattern that was positive for c-kit (CD 117) and CD 34. The postoperative course was uneventful, and no recurrence has been noted in the 2 years since the operation. This is the first report of a case with gastric GIST with an intra-abdominal abscess that was successfully treated by laparoscopic surgery.
机译:表现为腹腔内脓肿的胃胃肠道间质瘤(GIST)极为罕见。我们在这里报告的情况下,成功进行了腹腔内脓肿的胃GIST腹腔镜切除术。一名70岁的男子因发烧而出现急性上腹痛3天的病史。实验室数据显示白细胞计数和C反应蛋白水平升高。 CT扫描显示,在相邻的较小胃弯曲处,有大量混合的固体和流体成分,大小为5.5厘米。他被诊断患有腹腔内脓肿,并进行了抗生素治疗。因此,他的症状得到缓解,第7天的CT扫描显示肿块减少并变得均匀。根据细针穿刺活检的结果,该肿瘤被怀疑是GIST。采用五端口方法进行腹腔镜手术。肿瘤存在于胃小弯处,并通过楔形切除与大网膜和胃壁一起切除。肿瘤直径为3.0厘米,起源于胃的浆膜层。组织学检查结果显示梭形细胞的基质生长模式对c-kit(CD 117)和CD 34呈阳性。术后病程平稳,手术后2年内未发现复发。这是首次通过腹腔镜手术成功治疗胃GIST并伴有腹腔内脓肿的报道。

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