Gastrointestinal Stromal Tumor of the Stomach Mimicking Perigastric Abscess with Hepatic Portal Venous Gas: A Case Report

胃臟的胃腸道基質瘤模仿成胃臟旁膿瘍併肝門靜脈氣體：病例報告

蘇文科(Wen-Ko Su) ； 林義嵐(Yi-Lan Lin) ； 張國明(Kuo-Ming Chang) ； 林倩薏(Chien-Yi Lin)

《中華放射線醫學雜誌》 35卷2期 (2010/06) Pp. 103-107

摘要

胃腸道基質瘤是胃腸道的間質瘤中最常見的。我們報告的是一位五十八歲女性，其症狀是發燒及上腹痛。電腦斷層掃描顯現肝門靜脈氣體及一個七公分包含有氣體、液體、組織殘骸的薄璧囊狀病灶於胃臟的旁邊。初步診斷是胃臟旁膿瘍，於是施行了電腦斷層定位引流術。之後的膿瘍攝影及電腦斷層追蹤顯現只有輕微的膿瘍萎縮，另外還有一個小通道連通膿瘍及胃臟。最後腫瘤被切除了。組織學及免疫組織化學研究顯示出胃腸道基質瘤的特徵。據我們所知，這是第一例以胃臟旁膿瘍併肝門靜脈氣體來呈現的胃腸道基質瘤之病例報告。

並列摘要

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal (GI) tract. We present the case of a 58-year-old woman complaining of fever and epigastric pain. Computed tomography (CT) showed hepatic portal venous gas (HPVG) and a 7-cm thin-walled perigastric cystic mass containing mixed gas, fluid, and debris. CT-guided drainage was performed for a presumed perigastric abscess. Follow-up abscessogram and CT scan showed only mild shrinkage of the abscess cavity and a small communication with the gastric lumen. The cystic mass was there-fore excised. Histologic and immunohistochemical studies demonstrated features of a GIST. To our knowledge, this is the first reported case of GIST presenting as a perigastric abscess with HPVG.