Abstract:
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal (GI) tract, typically originating from the interstitial cells of Cajal. The clinical presentations are variable according to their size and shape but rarely present as a palpable abdominal mass. Pancreatic pseudocysts are common complications of chronic pancreatitis characterized by fluid collections surrounded by a non-epithelialized wall of fibrous and granulation tissue. Patients may present with non-specific symptoms like abdominal pain, nausea, and vomiting and they generally have a history of acute pancreatitis. Small pseudocysts often resolve spontaneously, but larger ones often become symptomatic and may lead to complications. It is rare to find both a GIST of the stomach and a pseudocyst of the pancreas in the same patient. We present a unique case of a giant GIST and a pancreatic pseudocyst in a 72-year-old male who was experiencing abdominal pain and distension. Imaging revealed a massive lesion originating from the posterior gastric wall, which resembled a pseudocyst, along with a distinct cystic lesion adjacent to the pancreatic body. During surgical exploration, a complex interplay of both pathologies was discovered, requiring a comprehensive resection approach. The successful outcome highlights the importance of careful evaluation and personalized management in such rare cases.
摘要:
胃肠道间质瘤(GIST)是胃肠道(GI)最常见的间质瘤,通常起源于Cajal的间质细胞。临床表现根据其大小和形状而变化,但很少表现为可触及的腹部肿块。胰腺假性囊肿是慢性胰腺炎的常见并发症,其特征是由纤维和肉芽组织的非上皮化壁包围的液体聚集。患者可能会出现非特异性症状,如腹痛,恶心,和呕吐,他们通常有急性胰腺炎病史。小假性囊肿常自发消退,但较大的往往会出现症状,并可能导致并发症。在同一患者中很少发现胃的GIST和胰腺的假性囊肿。我们介绍了一名72岁男性的巨大GIST和胰腺假性囊肿的独特病例,该男性正在经历腹痛和腹胀。影像学显示一个源自胃后壁的巨大病变,类似于假性囊肿,与胰腺体相邻的明显囊性病变。在手术探查期间,发现了两种病理的复杂相互作用,需要全面的切除方法。成功的结果突出了在这种罕见情况下仔细评估和个性化管理的重要性。