摘要
凹陷型胃腺瘤一般較困難也較少在手術切除前被篩檢出來，就我們所知在台灣還沒有這種病例被報告過。在此我們報告一例凹陷型胃腺瘤病例。病人為一81歲男性，在做全身健康檢查時，經由汎內視鏡檢查，發現一個1.8×1.2公分大的管狀絨毛性凹陷型胃腺瘤。依文獻記載，此種凹陷型腺瘤似乎比一般較常見之瘜肉狀腺瘤具有較高的癌化傾向。我們建議病人接受進一步的治療，但病人因氣喘、高齡等因素而拒絕。9個月後之汎內視鏡追蹤檢查，發現腺瘤之內視鏡形狀由凹陷型變成平面型，但病理顯微形態仍呈現原本之管狀絨毛形態。因凹陷型腺瘤似較一般常見之瘜肉狀腺瘤具有較高的癌化傾向，故我們仍建議此類病患應接受較積極的外科手術或經由內視鏡粘膜刮除處理或更密切的定期接受汎內視鏡追蹤檢查。
並列摘要
Depressed or flat adenoma of the stomach is rarely detected preoperatively. It had never been reported in Taiwan. We present an 81-year-old man who was found to have a gastric depressed tubulovillous adenoma with moderate dysplasia using results of an esophagogastro-duodenoscopic examination during a physical health examination. We recommended further treatment but it was refused by the patient due to his old age and poor pulmonary function. This depressed tubulovillous adenoma did not change in size but became flattened, with no remarkable histopathological changes or malignant transformation 9 months after the initial diagnosis by a follow-up endoscopy. A gastric depressed/flat adenoma has higher malignant potential than its polypoid counterpart. More aggressive treatments, such as surgical intervention or endoscopic mucosal resection (EMR) or intensive follow-up examinations using endoscopy are recommended for this special entity.
延伸閱讀
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