Unusual Presentation of a Gastrointestinal Tumor in Excluded Stomach - the Need to Think About the Hidden Enemy

Q4 Medicine

Surgery, Gastroenterology and Oncology Pub Date : 2021-01-01 DOI:10.21614/sgo-26-4-323

T. Guedes, D. Ferreira, José Ricardo Brandão, Jose Ramon Vizcaino, I. Pedroto

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Abstract

Obesity and its surgical treatment have been increasing in the last decade. Roux-en-Y gastric bypass (RYGB) is one of the most common procedures performed, resulting in an excluded stomach that can be the home of pre- and postoperative pathology. We present a case report of a 52 years-old man with melena and refractory anemia 2 years after RYGB. Although a possible etiology was found through esophagogastroduodenoscopy, the persistence of anemia determined the search for other causes. Additional abdominal CT revealed a tumoral mass in the excluded stomach with subsequent biopsy findings compatible with a gastrointestinal stromal tumor (GIST). Neoadjuvant imatinib therapy and surgery werewas performed confirming the diagnosis and showing GIST ulcerating the mucosa of the excluded stomach. After surgery, imatinib treatment was restarted and maintained so far with no recurrence of anemia. Malignancy of excluded stomach are frequently of epithelial origin and, to our knowledge, GIST occurrence is a very rare finding on an excluded stomach. This highlights the importance of considering the occurrence of hidden pathology in the excluded stomach, as well as the need for a high-qualityhigh quality EGD in pre-bariatric surgery evaluation.

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胃肠肿瘤的不寻常表现-需要考虑隐藏的敌人

在过去的十年里，肥胖及其手术治疗一直在增加。Roux-en-Y胃旁路术(RYGB)是最常见的手术之一，其结果是胃被排除在外，这可能是术前和术后病理的所在地。我们提出一个病例报告，52岁的男子黑黑和难治性贫血后2年RYGB。虽然通过食管胃十二指肠镜检查发现了可能的病因，但贫血的持续存在决定了寻找其他原因。另外的腹部CT显示在排除的胃有一个肿瘤肿块，随后的活检结果与胃肠道间质瘤(GIST)相符。新辅助伊马替尼治疗和手术证实诊断，并显示胃肠道间质瘤溃疡的胃粘膜排除。术后重新开始伊马替尼治疗并维持至今，无贫血复发。排除胃的恶性肿瘤经常是上皮起源，据我们所知，GIST的发生是一个非常罕见的发现排除胃。这突出了考虑排除胃中隐藏病理发生的重要性，以及在减肥前手术评估中需要高质量的EGD。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Surgery, Gastroenterology and Oncology Medicine-Gastroenterology

CiteScore

0.30

自引率

0.00%

发文量

期刊介绍： Starting with this issue "Annals of Fundeni Hospital", founded in 1996 as the scientific journal of the prestigious hospital Fundeni becomes "Journal of Translational Medicine and Research" (JTMR), an Journal of the Academy of Medical Sciences of Romania. Therefore, an 18 years old Journal, attested and indexed in Elsevier Bibliographic Databases, Amsterdam and also indexed in SCOPUS, is continuing a tradition of excellence that lasted almost two decades. The new title of the Journal is inspired first of all from the important developments of translational research In Fundeni Clinical Institute and the "C.C Iliescu Institute for Cardio-Vascular Diseases", in parallel with the national and international trend to promote and develop this important area or medical research. Although devoted mainly to translational research, JTMR will continue to promote both basic and clinical research.