Most primary aortoduodenal fistulas occur in the presence of an aortic aneurysm,which can be part of immunoglobulin G4(IgG4)-related sclerosing disease.We present a case who underwent endovascular grafting of an aorto...Most primary aortoduodenal fistulas occur in the presence of an aortic aneurysm,which can be part of immunoglobulin G4(IgG4)-related sclerosing disease.We present a case who underwent endovascular grafting of an aortoduodenal fistula associated with a high serum IgG4 level.A 56-year-old male underwent urgent endovascular reconstruction of an aortoduodenal fistula.The patient received antibiotics and other supportive therapy,and the postoperative course was uneventful,however,elevated levels of serum IgG,IgG4 and C-reactive protein were noted,which normalized after the introduction of steroid therapy.Control computed tomography angiography showed no endoleaks.The primary aortoduodenal fistula may have been associated with IgG4-related sclerosing disease as a possible complication of IgG4-related inflammatory aortic aneurysm.Endovascular grafting of a primary aortoduodenal fistula is an effective and minimally invasive alternative to standard surgical repair.展开更多
Surgical treatments including radical resection and local excision remain the main treatment for primary rectal gastrointestinal stromal tumors(GISTs). However,since patients with high-grade rectal GISTs have a higher...Surgical treatments including radical resection and local excision remain the main treatment for primary rectal gastrointestinal stromal tumors(GISTs). However,since patients with high-grade rectal GISTs have a higher risk of tumor recurrence and a shorter life expectancy,neoadjuvant treatment is necessary. In this case report,the efficacy of imatinib mesylate (IM)as a neoadjuvant therapy was assessed in an old man with malignant rectal GIST.The patient received IM preoperative treatment for a short period of one and a half months;at the end of the IM treatment, computed tomography scanning showed a markedly reduced tumor size and cystic changes of the tissue. At that time,a function sphincter-sparing surgery was performed.The histological examination of the resected specimen detected no tumor cells,but residual blood vessels and scattered inflammatory lymphocytes.After surgery,the patient has been followed up without additional IM treatment and remained disease-free for 57 mo.This case indicates that IM neoadjuvant therapy can dramatically improve the prognosis of rectal malignant GIST.展开更多
文摘Most primary aortoduodenal fistulas occur in the presence of an aortic aneurysm,which can be part of immunoglobulin G4(IgG4)-related sclerosing disease.We present a case who underwent endovascular grafting of an aortoduodenal fistula associated with a high serum IgG4 level.A 56-year-old male underwent urgent endovascular reconstruction of an aortoduodenal fistula.The patient received antibiotics and other supportive therapy,and the postoperative course was uneventful,however,elevated levels of serum IgG,IgG4 and C-reactive protein were noted,which normalized after the introduction of steroid therapy.Control computed tomography angiography showed no endoleaks.The primary aortoduodenal fistula may have been associated with IgG4-related sclerosing disease as a possible complication of IgG4-related inflammatory aortic aneurysm.Endovascular grafting of a primary aortoduodenal fistula is an effective and minimally invasive alternative to standard surgical repair.
基金The National Natural Science Foundation of China,No.30300152the Shanghai Science Technique Planning Foundation,No.064119622
文摘Surgical treatments including radical resection and local excision remain the main treatment for primary rectal gastrointestinal stromal tumors(GISTs). However,since patients with high-grade rectal GISTs have a higher risk of tumor recurrence and a shorter life expectancy,neoadjuvant treatment is necessary. In this case report,the efficacy of imatinib mesylate (IM)as a neoadjuvant therapy was assessed in an old man with malignant rectal GIST.The patient received IM preoperative treatment for a short period of one and a half months;at the end of the IM treatment, computed tomography scanning showed a markedly reduced tumor size and cystic changes of the tissue. At that time,a function sphincter-sparing surgery was performed.The histological examination of the resected specimen detected no tumor cells,but residual blood vessels and scattered inflammatory lymphocytes.After surgery,the patient has been followed up without additional IM treatment and remained disease-free for 57 mo.This case indicates that IM neoadjuvant therapy can dramatically improve the prognosis of rectal malignant GIST.
