直肠间质瘤致下消化道大出血1例报告

A Case Report of Massive Hemorrhage of Lower Digestive Tract by Rectal Stromal Tumor

胃肠道间质瘤是一种发生于消化道的少见的间叶肿瘤,直肠间质瘤更为罕见,在直肠肿瘤中的发生率0.1%以下。直肠间质瘤的临床表现无特异性,与其他直肠肿瘤相似,随肿瘤逐渐增大可表现为排便习惯改变、便血、排便困难等。临床确定诊断困难。手术治疗是能够治愈直肠间质瘤的唯一方法。格列卫作为一线化疗药物对术前降期及改善预后都有良好疗效。本例患者因下消化道大出血入院,肿瘤近肛缘,术中病理考虑为直肠间质瘤,完整切除肿瘤后行保肛术。术后应用格列卫,随诊3个月无复发、转移。

A Gastrointestinal stromal tumor （GIST） is an uncommon mesenchyma neoplasm of gastrointestinal tract, rectal stromal tumors are more rare, which are relatively rare in the rectum （〈0. 1%）. Rectal stromal tumor has few specific clinical manifestations, which is similar to other rectal tumors, when the tumor grew bigger, clinical manifestations of rectal stromal can change in bowel habits, hematochezia, difficultdefecation, etc. Clinical proven diagnosis is difficult. Operation is the only way to cure rectal stromal tumors. Imatinib as first-line chemotherapy drugs can confine or decrease the neoplasm before operation and is good for long-term prognosis. This case was hospitalized by massive hemorrhage of lower digestive tract. The neoplasm is near anal edge. Pathological diagnosis during the operation was rectal stromal tumors, we had complete tumor excision to anus preservation. Lmatinib is used after the operation, there are no reeurrence andmetastatic tumor follow-up clinic of 3 months.