背景:恶性胃血管球瘤(GGT)是一种极其罕见的间充质起源的恶性肿瘤,它影响病人的健康,甚至威胁生命。在没有预后研究的现有文献中,甚至很少报道具有血管侵袭的恶性GGT。所以,在这种情况下,我们报道了1例恶性GGT伴血管侵犯,并进行了5年的术后随访.据我们所知,我们报告了首例恶性GGT伴血管侵犯,术后5年无复发。这为恶性GGT伴血管侵犯的治疗提供了实例和教训。
方法:一名49岁男性因健康检查发现胆囊结石入院。在完成腹部CT和超声胃镜检查后,发现胃窦有肿块。
方法:术后病理结合SMA免疫组化阳性确诊为恶性GGT,波形蛋白,突触素,H-Caldesmon,还有Calponin,有丝分裂>10/50HPF和中度至重度核异型。
方法:在住院的第6天,患者接受了腹腔镜远端胃切除术和胆囊切除术。
结果:患者术后1周顺利出院,随访5年无复发。
结论:恶性GGT可以是无症状的。对于无远处转移的恶性GGT,尽管有血管侵犯,阴性切缘手术仍可作为标准的手术根治性治疗方法。
BACKGROUND: Malignant gastric glomus tumor (GGT) is an extremely rare malignant tumor of mesenchymal origin, it affects the patient\'s health and even threatens life. Malignant GGT with vascular invasion is even more rarely reported in the available literature without a prognostic study. So, in this case, we report a malignant GGT with vascular invasion and performed a 5-year postoperative follow-up. To the best of our knowledge, we report the first case of malignant GGT with vascular invasion without recurrence 5 years after surgery. This provides examples and lessons for the treatment of malignant GGT with vascular invasion.
METHODS: A 49-year-old male was admitted to the hospital with gallbladder stones found on health check. After completing abdominal CT and ultrasound gastroscopy, a mass in the gastric antrum was found.
METHODS: The diagnosis of malignant GGT was confirmed by combination of postoperative pathology with positive immunohistochemistry for SMA, vimentin, synaptophysin, H-caldesmon, and calponin, mitosis > 10/50 HPF and moderate-to-severe nuclear atypia.
METHODS: On the 6th day of hospitalization, the patient underwent laparoscopic distal gastrectomy and cholecystectomy.
RESULTS: The patient was discharged successfully 1 week after surgery and was followed up for 5 years without recurrence.
CONCLUSIONS: Malignant GGT can be asymptomatic. For malignant GGT without distant metastasis, despite the presence of vascular invasion, negative margin surgery can still be the standard surgical radical treatment.