Jejunal Gastrointestinal Stromal Tumors with Liver Metastasis: Report of a Case

腸胃道基質瘤(GIST)被認為是源自腸胃道的間質性腫瘤。臨床上病患通常以腹部不適，可觸摸到腫塊，或是消化道出血表現。大約70%的腫瘤在胃被發現，20-30%的腫瘤出現在小腸，小於10%在其他腸胃部位，偶爾會在腹膜，網膜的地方被找到。腸胃道基質瘤最常見的轉移部位是肝臟，我們提出一個病例是一位五十三歲的女性，她最初是以解黑便為臨床表現合併腹脹的原因到醫院求診，經檢查後發現是空腸的腸道基質腫瘤出血及合併肝臟轉移情形。腫瘤的大小及細胞分裂指數為最常用的預後評估因子，例如腫瘤大小直徑大於五公分以及高有絲分裂指數（大於5/50HPF）為預後不良。腸胃道基質瘤的標的物(Target)治療是一項重要的突破也帶來相當的益處。

關鍵字

腸胃道基質瘤GIST ； CD-117 ；肝臟轉移；預後因子； Imatinib mesylate

並列摘要

Gastrointestinal stromal tumors (GISTs), previously presumed to be of smooth muscle origin, represent a distinct but heterogeneous group of neoplasms with respect to their molecular etiology and cellular origin. Patients usually present with abdominal discomfort, a palpable mass, or GI bleeding. About 70% of tumors occur in the stomach, 20%~30% in the small intestine, and fewer than 10% in other locations of the GI tract and occasionally in the peritoneum, omentum, and retroperitoneum. The liver is the most common organ of metastasis along with local recurrence and invasion to the peritoneum. Lymph node metastasis is rare. We present a 53-year-old woman who had a jejunal tumor with liver involvement initially showing tarry stool passage. In serial studies, GIST with liver metastasis was the final diagnosis. Tumor size and the mitotic index are the 2most frequently used prognostic factors: a large tumor (＞5 cm) and a high mitotic index (＞5/50 high power fields) indicate a poor prognosis. A critical breakthrough was recently made in molecularly targeted treatment and prognosis of GISTs. Imatinib mesylate (Gleevec) has been shown to have benefits and encouraging progress.

並列關鍵字

gastrointestinal stromal tumor GIST ； CD-117 ； liver metastasis ； prognostic factor ； Imatinib mesylate

國際替代計量

Jejunal Gastrointestinal Stromal Tumors with Liver Metastasis: Report of a Case

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