胃肠间质瘤与妇科肿瘤的相似——一个病例系列。

IF 1.1 Q4 PRIMARY HEALTH CARE Journal of Family Medicine and Primary Care Pub Date : 2024-12-01 Epub Date: 2024-12-09 DOI:10.4103/jfmpc.jfmpc_511_24
Kiran Trivedi, Shabnam Toppo, Apoorwa Sharma, Rohit Kumar Jha, Binit Bharati, Pushpanjali, Tulika Sinha
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引用次数: 0

摘要

胃肠道间质瘤(gist)是一种罕见的间质肿瘤,起源于Cajal间质细胞。由于表现模糊,位置和影像学研究混乱,它们倾向于模仿妇科肿瘤。通常是术中和组织病理学诊断,肿瘤特异性受体如KIT、CD34、cd117和DOG 1是GIST诊断的主要依据。gist的预后取决于有丝分裂率、肿瘤大小和起源器官。切除无瘤缘肿块是治疗的目标。L淋巴结切除术不是常规手术。酪氨酸激酶抑制剂如伊马替尼、达沙替尼、索拉非尼的化疗和随访取决于风险类别。在这个病例系列中,有四个病例的模糊症状误诊为妇科肿瘤。术前推定为妇科来源的肿瘤为术中gist病例,经cajal细胞组织病理学检查和免疫组化主要通过dog1、CD117和酪氨酸激酶抑制剂受体证实。均属于gist的高危类别。超声检查发现的任何腹部-骨盆肿块以及在初级保健中心出现的异常表现,都应牢记非妇科肿瘤的可能性,特别是胃肠道间质瘤,并应转诊到更高一级的中心进行进一步的检查和适当的治疗。
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Gastrointestinal stromal tumors mimicking as gynecological tumors-A case series.

Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors that arise from interstitial cells of Cajal. Due to vague presentation, location and confusing imaging studies, they tend to mimic gynaecological tumors. They usually diagnosed intra-operative and histopathology followed by tumor specific receptors such as KIT, CD34, CD 117 and DOG 1 are mainstay of diagnosis of GIST. Prognosis of GISTs depends on mitotic rate, tumor size and organ of origin. Resection of mass with tumor free margins is the target of treatment. L ymphadenectomy is not routine. Chemotherapy with tyrosine kinase inhibitors such as Imatinib, Dasatinib, Sorafenib and follow- up depend upon risk category. In this case series, there were four cases with vague symptoms misdiagnosed as gynaecological tumors are reviewed. Preoperatively tumors assumed to be of gynaecological origin were found to be case of GISTs intra-operatively and confirmed by presence of cajal's cells histopathology and mainly by DOG 1, CD117 and tyrosine kinase inhibitor receptors on immunohistochemistry. All belonged to high risk category of GISTs. Any abdomino-pelvic mass detected on ultrasonography and with unusual presentation presenting at primary health centre the possibility of non-gynecological tumors especially GISTs should be kept in mind and should be referred to higher centres for further investigation and proper management.

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