35岁女性胃窦恶性球囊瘤伴肝转移1例

Emery M. Cuellar, L. Kenney, M. Hughes
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摘要

血管球瘤(Glomus tumor, GTs)是源自血管球体改良的平滑肌细胞的间充质肿瘤。这些肿瘤占所有软组织肿瘤的不到2%,其中不到1%为恶性肿瘤。一位35岁的非裔美国女性表现为症状性缺铁性贫血。食管胃十二指肠镜检查发现一个5厘米的肿块部分阻塞了胃窦,并进行了组织活检。活检显示低级别上皮间充质肿瘤伴血管球瘤特征。随访胸部/腹部/骨盆CT显示胃窦有一个5厘米的相对均匀的实性肿块,与胃肠道间质瘤最相似。在计划的远端胃切除术重建中,术中超声发现1例肝转移灶,并经冷冻切片会诊证实与胃窦肿块的组织学类型相同。病理和免疫组化结果符合恶性胃球囊瘤伴肝转移。大多数GTs有一个良性的临床过程,使得恶性GTs的诊断和治疗是一个持续的挑战。由于这些肿瘤的罕见性,有关脏器血管球瘤的资料有限,大多数已知的表现和治疗方法都来自病例报告。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Malignant Glomus Tumor of the Gastric Antrum with Liver Metastasis in a 35-year-old Female: A Case Report
Glomus tumors (GTs) are mesenchymal tumors derived from modified smooth muscle cells of the glomus body. These tumors account for less than 2% of all soft tissue tumors, and of those less than 1% are malignant. A 35-year-old African American female presented with symptomatic iron deficiency anemia. On esophagogastroduodenoscopy, a 5 cm mass was seen partially obstructing the antrum and tissue biopsy was obtained. The biopsy showed low-grade epithelial mesenchymal neoplasm with features of a glomus tumor. A follow up computed tomography (CT) chest/abdomen/pelvis revealed a 5 cm relatively homogeneous solid mass in the gastric antrum, which appeared most similar to a gastrointestinal stromal tumor. During the planned distal gastrectomy with reconstruction, one hepatic metastasis was identified via intraoperative ultrasound and was confirmed by frozen section consultation to be the same histologic type as the antral mass. Pathologic and immunohistochemical findings were consistent with a malignant gastric glomus tumor with liver metastasis. Most GTs have a benign clinical course making the diagnosis and treatment of malignant GTs an ongoing challenge. The data on glomus tumors of the viscera is limited by the rarity of these tumors, with most of the known presentation and treatment gathered from case reports.
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