食管黏膜下肿瘤F-18fdgpet/CT诊断为恶性病变的良性神经鞘瘤电视胸腔镜摘除术

IF 2.3 3区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY
Sung Kwang Lee
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引用次数: 0

摘要

食管SMT是一种罕见的疾病,大多数是良性的。食管神经鞘瘤在食管SMT中约占2%。最近,F-18FDGPET/CT已被广泛用于癌症患者的恶性肿瘤或其他转移病灶的确认。然而,即使是良性肿瘤也经常表现出SUV升高,在神经鞘瘤的情况下,SUV的各种值已经被报道,这似乎限制了与其他恶性周围神经鞘肿瘤的鉴别。一位56岁的女性患者偶然发现在离切牙22厘米处有外源性压迫性肿块。内窥镜超声和胸部CT显示,食道上部有一个3.4厘米大小的均匀明确的肿块,怀疑是平滑肌瘤或胃肠道间质瘤。SUV在PET-CT上升高,以确定恶性肿瘤和转移性病变。当被确认为恶性时,计划进行额外的手术,并进行摘除以进行初步诊断和治疗。食道膨出已被证实。食管肌切开后,行摘除术。免疫组化染色显示S-100蛋白阳性,可诊断为神经鞘瘤。由于食管SMT的特点,PET-CT上可能观察到FDG的摄取,但如果没有转移的证据,则可能根据良性疾病进行治疗。然后,如果免疫组织化学检查被诊断为恶性肿瘤,则需要进行额外阶段的手术。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
342. VIDEO-ASSISTED THORACOSCOPIC ENUCLEATION OF BENIGN SCHWANNOMA MISDIAGNOSED AS MALIGNANT LESION ON F-18 FDG PET/CT IN ESOPHAGEAL SUBMUCOSAL TUMOR
Esophageal SMT is a rare disease, and most of them are benign. Esophageal schwannoma accounts for about 2% among esophageal SMT. Recently, F-18 FDG PET/CT has been widely used to confirm malignancy or to identify other metastatic lesions in cancer patients. However, even benign tumors often show an elevated SUV, and in the case of schwannomas, various values of SUV have been reported, which seems to limit differentiation from other malignant peripheral nerve sheath tumors. A 56-year-old female patient was incidentally found with extrinsic compressing mass at 22 cm from the incisor. An endoscopic ultrasonography and chest CT showed a 3.4 cm sized homogenous well-defined mass in upper esophagus, leiomyoma or gastrointestinal stromal tumor was suspected. SUV was elevated on PET-CT was performed to identify malignancy and metastatic lesions. When confirmed as malignant, additional surgery was planned, and enucleation was performed for primary diagnosis and treatment. The esophageal bulging was confirmed. After dividing the esophageal muscle, and underwent enucleation. In immunohistochemical staining, S-100 protein showed positive findings, which could be diagnosed as schwannoma. Due to the characteristics of esophageal SMT, FDG uptake may be observed on PET-CT, but if there is no evidence of metastasis, it is likely to proceed with treatment according to the benign disease. Then, if immunohistochemistry examination is diagnosed as malignancy, it would be desirable to apply additional stage surgery.
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来源期刊
Diseases of the Esophagus
Diseases of the Esophagus 医学-胃肠肝病学
CiteScore
5.30
自引率
7.70%
发文量
568
审稿时长
6 months
期刊介绍: Diseases of the Esophagus covers all aspects of the esophagus - etiology, investigation and diagnosis, and both medical and surgical treatment.
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