Synchronous gastric leiomyoma and intramuscular abdominal wall granular cell tumor with similar imaging features: A case report.
Synchronous gastric leiomyoma and intramuscular abdominal wall granular cell tumor with similar imaging features: A case report.
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DOI：
10.1016/j.ijscr.2018.03.001
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发表时间：
2018
影响因子：
0.6
通讯作者：
Sata N
中科院分区：
文献类型：
--
作者：
Saito S;Yan C;Fukuda H;Hosoya Y;Matsumoto S;Matsubara D;Kitayama J;Lefor AK;Sata N
腹壁颗粒细胞瘤是罕见的。间充质肿瘤在诊断成像研究中可能有类似的发现。腹腔镜-内窥镜联合手术可用于胃粘膜下肿瘤的切除。胃平滑肌瘤是良性间质肿瘤，约占胃肿瘤的2.5%，与具有恶性潜能的胃肠道间质瘤很难区分。腹壁的颗粒细胞瘤也很少见。由于间充质肿瘤难以通过影像学诊断，需要进一步的研究来确定诊断。一名60岁无症状妇女接受常规上胃镜检查，发现胃粘膜下病变。计算机断层扫描也显示腹壁肿块。两种病变在影像学上的表现相似，但尚不清楚这两种病变是否有相同的起源。内镜下超声引导下的胃病变细针穿刺活检不足以确定诊断。腹腔镜-内镜联合切除胃病变和超声引导下腹壁肿块芯针活检使两种病变的病理诊断成为可能。这两种病变的影像学诊断结果相似。组织学和免疫组织化学研究是建立明确诊断的必要条件。腹腔镜-内镜联合手术可能是一种有效的微创方法，既能进行病理诊断，又能完全切除胃粘膜下肿瘤，特别是当内镜-超声引导下细针穿刺或活检不能诊断时。腹腔镜-内窥镜联合手术是一种有效的微创手术。这是第一例同时伴有胃平滑肌瘤和腹壁肌内颗粒细胞瘤的病例。
Granular cell tumors of the abdominal wall are rare. Mesenchymal tumors may have similar findings on diagnostic imaging studies. Laparoscopic-endoscopic cooperative surgery may useful to resect gastric submucosal tumors. Gastric leiomyomas are benign mesenchymal tumors, comprising about 2.5% of gastric neoplasms, which can be difficult to differentiate from gastrointestinal stromal tumors which have malignant potential. Granular cell tumors in the abdominal wall are also rare. Since mesenchymal tumors are difficult to diagnose by imaging, further studies are needed to establish the diagnosis. A 60-year-old asymptomatic woman underwent routine upper endoscopy and was found to have a gastric submucosal lesion. Computed tomography scan also showed an abdominal wall mass. The appearance of both lesions on imaging studies were similar, but it was unclear if the two lesions had the same origin. Endoscopic ultrasound-guided fine needle aspiration biopsy of the gastric lesion was insufficient to establish the diagnosis. Laparoscopic-endoscopic cooperative resection of the gastric lesion and ultrasound-guided core-needle biopsy of the abdominal wall mass enabled pathological diagnosis of both lesions. Diagnostic imaging findings of these two lesions were similar. Histologic and immunohistochemical studies are essential to establish a definitive diagnosis. Laparoscopic-endoscopic cooperative surgery may be an effective minimally invasive approach, allowing both pathological diagnosis and complete resection of a gastric submucosal tumor, especially when endoscopic-ultrasound guided fine needle aspiration or biopsy fails to make the diagnosis. Laparoscopic-endoscopic cooperative surgery can be an effective minimally invasive approach to resect some lesions. This is first report of the patient with a synchronous gastric leiomyoma and an intramuscular granular cell tumor in the abdominal wall.