Synchronous Duodenal and Jejunal Gastrointestinal Stromal Tumors

A. Petroianu, K. Sabino, Michelle A. Couto
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Abstract

BACKGROUND Gastrointestinal stromal tumor (GIST) constitutes up to 1% of all malignant neoplasms of the gastrointestinal tract, with the stomach and small intestine being the most frequently affected organs. The purpose of this report is to present the first published case of synchronous duodenal and jejunal GISTs. CASE REPORT A 57-years old male patient with type II diabetes complained of asthenia and vertigo, resulting from anemia. On upper digestive endoscopy, a friable lesion was found in the second portion of the duodenum. The biopsy diagnosed GIST and its removal was indicated. During the surgical procedure, a second tumor was found in the jejunum, which was also removed. Anatomopathological examination of this second lesion also revealed GIST with the same cytological features. Digestive reconstruction was performed in Roux-en-Y of the jejunum sectioned distally to the tumor with the open part of the duodenum. The patient evolved without complications, was discharged on the third postoperative day and has been followed up for eleven years without any other treatment and without neoplastic recurrence. Food transit occurs almost exclusively through the duodenum. CONCLUSION This is the first report of two synchronous GISTs of duodenum and jejunum. After removal of both tumors, the Roux-en-Y reconstruction adequately closed the opened duodenum, but food transit persisted physiological through the duodenum.
同时性十二指肠和空肠胃肠道间质瘤
胃肠道间质瘤(GIST)占胃肠道所有恶性肿瘤的1%,其中胃和小肠是最常见的受累器官。本报告的目的是提出首次发表的病例同步十二指肠和空肠胃肠道间质瘤。病例报告一名57岁男性II型糖尿病患者,主诉贫血引起的虚弱和眩晕。在上消化道内窥镜检查中,发现一易碎的病变位于十二指肠的第二部分。活检诊断为GIST并提示切除。在手术过程中,在空肠发现了第二个肿瘤,也被切除了。第二个病变的解剖病理检查也显示GIST具有相同的细胞学特征。在Roux-en-Y空肠与肿瘤远端切开的十二指肠部分进行消化重建。患者无并发症发生,术后第三天出院,随访11年,无其他治疗,无肿瘤复发。食物运输几乎完全通过十二指肠。结论这是首次报道十二指肠和空肠同时发生的胃肠道间质瘤。切除两个肿瘤后,Roux-en-Y重建充分关闭了打开的十二指肠,但食物通过十二指肠的转运仍然是生理的。
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