Synchronous Ileal Stromal Tumor (GIST) and Colonic Adenocarcinoma

同時合併迴腸間質瘤及大腸癌：病例報告

邱信輝(Hsin-Hui Chiu) ； 黃太謙(Tai-Chien Huang) ； 劉耀文(Yao-Wen Liu) ； 柯天龍(Tien-Lung Ko) ； 盧乃寬(Nai-Kuan Lu)

《內科學誌》 20卷3期 (2009/06) Pp. 260-263

https://doi.org/10.6314/JIMT.2009.20(3).10

摘要

同時合併胃腸道間質瘤及大腸直腸癌在臨床上較少被報導。我們報告一例84歲女性病患因3天腹痛及便秘之後併有嘔吐之情形而入院。之前有8個月間歇性腹痛之病史。腹部X光呈現小腸和橫結腸及近端之大腸部份有擴大之現象，鋇劑灌腸及大腸鏡檢查發現一環狀腫瘤在大腸之脾臟轉彎處。另外腹部電腦斷層意外發現另一5公分腫瘤在迴腸處。經由開刀，術後病理組織切片結果發現大腸腫瘤為一分化良好的腺癌，而迴腸腫瘤經免疫生化染色(CD117)証實為胃腸道間質瘤。病人症狀完全改善在住院第18天出院且之後接受常規大腸癌化學治療。

並列摘要

Synchronous existence of gastrointestinal stromal tumor and colonic adenocarcinoma was rarely reported. We describe an 84-year-old female presenting with abdominal pain and obstipation followed by vomiting for 3 days. There was intermittent abdominal pain of 8 months' duration. Plain abdominal film revealed marked dilatation of the intestine proximal to the descending colon. An annular tumor was radiologically and endoscopically demonstrated in the splenic flexure of the colon. Computed tomographic scans of the abdomen had an incidental finding of a 5-cm tumor mass in the ileum. After surgical resection of both tumor lesions, the colon tumor lesion was pathologically proven to be a well-differentiated adenocarcinoma (Duck's stage C2) and another tumor from the ileum showed positive reactivity to CD 117 immunohistochemical staining consisting with gastrointestinal stromal tumor. The patient was discharged on the 18th hospital day and subsequently underwent chemotherapy (Ufur containing 100 mg Tegafur and 224 mg Uracil).

並列關鍵字

Gastrointestinal stromal tumor ； Colon cancer ； CD 117