肝脏原发性胃肠间质瘤术后复发1例报告

刘康伟; 耿新; 王磊; 彭慈军

doi:10.3969/j.issn.1001-5256.2021.12.031

肝脏原发性胃肠间质瘤术后复发1例报告

DOI: 10.3969/j.issn.1001-5256.2021.12.031

遵义医科大学附属医院肝胆外科，贵州遵义 563000

基金项目:

国家自然科学基金 (81660688)

详细信息

通信作者:
彭慈军，doctorpengcijun@163.com

中图分类号: R735.7
计量
- 文章访问数: 490
- HTML全文浏览量: 93
- PDF下载量: 28
- 被引次数: 0
出版历程
- 收稿日期: 2021-04-29
- 录用日期: 2021-06-11
- 出版日期: 2021-12-20

Recurrence after hepatectomy for primary gastrointestinal stromal tumor of the liver: A case report

Department of Hepatobiliary Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou 563000, China

Research funding:

National Natural Science Foundation of China (81660688)

摘要

- 胃肠道间质肿瘤 /
- 肝疾病 /
- 复发
- Gastrointestinal Stromal Tumors /
- Liver Diseases /
- Recurrence

HTML全文

图 1 腹部增强CT

注：a, 动脉期；b：静脉期。肝左叶体积明显增大并见不规则低密度影，突出肝轮廓之外，边缘见环形稍高密度影，大者约99 mm×74 mm，增强扫描明显不均匀强化，边缘强化明显，静脉期高于肝实质密度。

下载: 全尺寸图片幻灯片

图 2 腹部MRI

注：a, T1像；b, T2像；c, 腹部增强MRI。肝左叶体积明显增大，形态不规则，见多个囊实性肿块突出于肝脏轮廓之外，较大者约11 cm×9 cm，肿块实性部分呈长T1、稍长T2信号，增强扫描病灶明显不均匀环状强化，囊壁薄厚不均。

下载: 全尺寸图片幻灯片

图 3 病理结果

注：a, 病灶HE染色(×400)；b, 病灶免疫组化(×40)。左侧肝脏恶性肿瘤，(肝脏)胃肠道间质瘤，CD34(+)、CD117(灶+)、Dog-1(灶+)。

下载: 全尺寸图片幻灯片

参考文献(15)

[1]	OCHIAI T, SONOYAMA T, KIKUCHI S, et al. Primary large gastrointestinal stromal tumor of the liver: Report of a case[J]. Surg Today, 2009, 39(7): 633-636. DOI: 10.1007/s00595-008-3885-5.
[2]	QIAN XH, YAN YC, GAO BQ, et al. Prevalence, diagnosis, and treatment of primary hepatic gastrointestinal stromal tumors[J]. World J Gastroenterol, 2020, 26(40): 6195-6206. DOI: 10.3748/wjg.v26.i40.6195.
[3]	ZHANG CG, LIU SL, ZHOU JP, et al. Liver metastasis of small intestinal stromal tumor misdiagnosed as liver cancer: A case report[J]. J Clin Hepatol, 2017, 33(3): 519-520. DOI: 10.3969/j.issn.1001-5256.2017.03.025. 张从贵, 刘守领, 周建鹏, 等. 小肠间质瘤肝转移误诊为肝癌1例报告[J]. 临床肝胆病杂志, 2017, 33(3): 519-520. DOI: 10.3969/j.issn.1001-5256.2017.03.025.
[4]	FERNANDES MR, GHEZZI C, GREZZANA-FILHO TJ, et al. Giant hepatic extra-gastrointestinal stromal tumor treated with cytoreductive surgery and adjuvant systemic therapy: A case report and review of literature[J]. World J Gastrointest Surg, 2021, 13(3): 315-322. DOI: 10.4240/wjgs.v13.i3.315.
[5]	ILIE CA, RUSU MC, DIDILESCU AC, et al. Embryonic hematopoietic stem cells and interstitial Cajal cells in the hindgut of late stage human embryos: Evidence and hypotheses[J]. Ann Anat, 2015, 200: 24-29. DOI: 10.1016/j.aanat.2015.01.001.
[6]	KIM HO, KIM JE, BAE KS, et al. Imaging findings of primary malignant gastrointestinal stromal tumor of the liver[J]. Jpn J Radiol, 2014, 32(6): 365-370. DOI: 10.1007/s11604-014-0307-z.
[7]	CAO L, XIE YH, ZHAO L, et al. One case: Primary malignant stromal tumor of the liver[J]. Chin J CT and MRI, 2020, 18(6): 151-152. DOI: 10.3969/j.issn.1672-5131.2020.06.047. 曹莉, 谢玉海, 赵雷, 等. 肝脏原发性恶性间质瘤一例[J]. 中国CT和MRI杂志, 2020, 18(6): 151-152. DOI: 10.3969/j.issn.1672-5131.2020.06.047.
[8]	YAN JZ, LIU YH. One case: Primary stromal tumor of the caudate lobe[J]. Trauma and Critical Care Medicine, 2016, 4(3): 189-191. DOI: 10.16048/j.issn.2095-5561.2016.03.18. 严京哲, 刘亚辉. 原发性肝尾叶间质瘤1例[J]. 创伤与急危重病医学, 2016, 4(3): 189-191. DOI: 10.16048/j.issn.2095-5561.2016.03.18.
[9]	JOYON N, DUMORTIER J, ALINE-FARDIN A, et al. Gastrointestinal stromal tumors (GIST) presenting in the liver: Diagnostic, prognostic and therapeutic issues[J]. Clin Res Hepatol Gastroenterol, 2018, 42(2): e23-e28. DOI: 10.1016/j.clinre.2017.05.010.
[10]	YE SL. Downstaging and conversion treatment of intermediate and advanced liver cancer should be taken seriously[J]. J Clin Hepatol, 2020, 36(2): 249-251. DOI: 10.3969/j.issn.1001-5256.2020.02.001. 叶胜龙. 重视中晚期肝癌的降期转化治疗[J]. 临床肝胆病杂志, 2020, 36(2): 249-251. DOI: 10.3969/j.issn.1001-5256.2020.02.001.
[11]	YANG XL, ZHANG JP. Progress in molecular targeting therapy for gastrointestinal stromal tumors[J]. Chin J Cancer Biother, 2019, 26(3): 253-259. DOI: 10.3969/j.issn.1001-5256.2020.02.001. 杨晓玲, 张俊萍. 胃肠道间质瘤分子靶向治疗的研究进展[J]. 中国肿瘤生物治疗杂志, 2019, 26(3): 253-259. DOI: 10.3969/j.issn.1001-5256.2020.02.001.
[12]	SHEN L, LI J, QIN SK, et al. Chinese consensus guidelines for diagnosis and management of gastroin testinal stromal tumor(2013)[J]. Chin J Gastrointestinal Surg, 2014, 17(4): 393-398. DOI: 10.3760/cma.j.issn.1671-0274.2014.04.022. 沈琳, 李健, 秦叔逵, 等. 中国胃肠间质瘤诊断治疗共识(2013年版)[J]. 中华胃肠外科杂志, 2014, 17(4): 393-398. DOI: 10.3760/cma.j.issn.1671-0274.2014.04.022.
[13]	JOENSUU H, ERIKSSON M, SUNDBY HALL K, et al. One vs three years of adjuvant imatinib for operable gastrointestinal stromal tumor: A randomized trial[J]. JAMA, 2012, 307(12): 1265-1272. DOI: 10.1001/jama.2012.347.
[14]	de CHIARA A, de ROSA V, LASTORIA S, et al. Primary gastrointestinal stromal tumor of the liver with lung metastases successfully treated with STI-571 (imatinib mesylate)[J]. Front Biosci, 2006, 11: 498-501. DOI: 10.2741/1813.
[15]	GAO XD, XUE AW, FANG Y, et al. Efficacy analysis of targeted therapy combined with surgery in the treatment of recurrent and metastatic gastrointestinal[J]. Chin J Gastrointestinal Surg, 2016, 19(11): 1282-1285. DOI: 10.3760/cma.j.issn.1671-0274.2016.11.016. 高晓东, 薛安慰, 方勇, 等. 靶向药物联合手术治疗复发转移胃肠间质瘤患者的疗效分析[J]. 中华胃肠外科杂志, 2016, 19(11): 1282-1285. DOI: 10.3760/cma.j.issn.1671-0274.2016.11.016.