大網原発巨大GIST の1切除例

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  • ショウレイ ホウコク ダイモウ ゲンパツ キョダイ GIST ノ 1 セツジョレイ
  • A case of Giant Gastrointestinal Stromal Tumor Primarily Occurred in the Greater Omentum
  • ダイモウ ゲンパツ キョダイ GIST 1セツジョレイ

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Abstract

We report a case of giant gastrointestinal stromal tumor(GIST)primarily occurred in the greater omentum. A78-year-old woman was referred to our hospital because of a giant abdominal tumor. Contrast-enhanced abdominal computed tomography(CT)showed a giant tumor measuring 20×24×13cm in diameter in the abdominal cavity, consisting of heterogeneously enhanced solid and cystic lesions. Abdominal magnetic resonance imaging(MRI)after 3 weeks from the first medical examination showed the enlarged tumor measuring24×25×17cm in diameter, the intensity of the solid lesion was low on T1weighted image, heterogeneously enhanced on T2weighted image and high on diffusion weighted image. At surgery, we confirmed the giant tumor continued to the omentum, and pressured the stomach, pancreas, and colon. The resected specimen weighed 8,325g containing of5,640ml of red-brown fluid. Histological examination showed the tumor consisted of proliferated spindle cells in a fascicular pattern and polynesic hemorrhage and necrosis. Immunohistochemically, the tumor cells were positive for c-kit and CD34, and negative for S‐100 protein and desmin, indicating a GIST in the greater omentum. The mitotic figures were in a40/50 high power field. In genetic testing, the tumor cells had exon11mutation of c-kit gene. The woman started taking imatinib after operation and remains alive and recurrence-free.

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