BACKGROUND Gastric origin tumors were diagnosed and evaluated preoperatively by gastroscopy,endoscopic ultrasonography,computed tomography(CT)or magnetic resonance imaging.Currently,transabdominal high-resolution ultr...BACKGROUND Gastric origin tumors were diagnosed and evaluated preoperatively by gastroscopy,endoscopic ultrasonography,computed tomography(CT)or magnetic resonance imaging.Currently,transabdominal high-resolution ultrasound combined with gastrointestinal contrast agent can be used to diagnose stomach tumors effectively and without invasive procedures or radiation.However,although an appreciable number of cases of gastric schwannoma(GS)have been reported since the first description of such in 1988,the ongoing lack of a comprehensive list of ultrasonic characteristics has limited the accuracy of preoperative ultrasound diagnosis.CASE SUMMARY A 64-year-old female patient presented to our hospital with dizziness and head discomfort.During an abdominal ultrasound,a hypoechoic gastric mass was found,having clear and regular boundaries and no observable blood flow.Based on these characteristics,a gastrointestinal stromal tumor was suspected.Results from an endoscopic ultrasound biopsy and accompanying immunohistochemical analysis,coupled with abdominal CT findings indicating lymph node enlargement around the stomach,led to diagnosis of GS but did not exclude malignancy.After surgical resection of the tumor,the final diagnosis of GS without lymph node metastasis was made.No recurrence has occurred in the 6 years of follow-up.CONCLUSION A clearly defined ultrasonic characteristic profile of GS is important to improve diagnostic accuracy.展开更多
BACKGROUND Clear cell sarcoma-like tumor of the gastrointestinal tract(CCSLGT)is a rare malignant gastrointestinal mesenchymal soft tissue tumor.Its genetic feature is EWSR1 gene rearrangement.Histologically,it is oft...BACKGROUND Clear cell sarcoma-like tumor of the gastrointestinal tract(CCSLGT)is a rare malignant gastrointestinal mesenchymal soft tissue tumor.Its genetic feature is EWSR1 gene rearrangement.Histologically,it is often accompanied by a varying number of CD68-positive osteoclast-like giant cells.CCSLGT mostly occurs in the small intestinal wall of young people and children.In terms of clinical manifestations,there is no significant difference between it and other gastrointestinal tumors,and the diagnosis depends on immunohistochemistry and gene detection.CASE SUMMARY A 16-year-old man developed dizziness and fatigue 2 mo ago,and 10 d ago showed progressive exacerbation of paroxysmal epigastric pain and stopped flatulence and defecation.Computed tomography showed a soft tissue mass in the distal ileum.After complete resection of the lesion,it was diagnosed by combined immunohistochemical and genetic examination as CCSLGT.After surgery,the patient gradually developed lymph node,liver,lung,bone,left thigh,pleura and adrenal metastasis.The survival time was 4 years and 8 mo.CONCLUSION Whole abdominal computed tomography enhancement is recommended for patients with gastrointestinal symptoms.There is no effective treatment for CCSLGT with multiple metastases via the lymphatic system and bloodstream after surgical resection.展开更多
基金Supported by the National Natural Science Foundation of China,No.82001819.
文摘BACKGROUND Gastric origin tumors were diagnosed and evaluated preoperatively by gastroscopy,endoscopic ultrasonography,computed tomography(CT)or magnetic resonance imaging.Currently,transabdominal high-resolution ultrasound combined with gastrointestinal contrast agent can be used to diagnose stomach tumors effectively and without invasive procedures or radiation.However,although an appreciable number of cases of gastric schwannoma(GS)have been reported since the first description of such in 1988,the ongoing lack of a comprehensive list of ultrasonic characteristics has limited the accuracy of preoperative ultrasound diagnosis.CASE SUMMARY A 64-year-old female patient presented to our hospital with dizziness and head discomfort.During an abdominal ultrasound,a hypoechoic gastric mass was found,having clear and regular boundaries and no observable blood flow.Based on these characteristics,a gastrointestinal stromal tumor was suspected.Results from an endoscopic ultrasound biopsy and accompanying immunohistochemical analysis,coupled with abdominal CT findings indicating lymph node enlargement around the stomach,led to diagnosis of GS but did not exclude malignancy.After surgical resection of the tumor,the final diagnosis of GS without lymph node metastasis was made.No recurrence has occurred in the 6 years of follow-up.CONCLUSION A clearly defined ultrasonic characteristic profile of GS is important to improve diagnostic accuracy.
文摘BACKGROUND Clear cell sarcoma-like tumor of the gastrointestinal tract(CCSLGT)is a rare malignant gastrointestinal mesenchymal soft tissue tumor.Its genetic feature is EWSR1 gene rearrangement.Histologically,it is often accompanied by a varying number of CD68-positive osteoclast-like giant cells.CCSLGT mostly occurs in the small intestinal wall of young people and children.In terms of clinical manifestations,there is no significant difference between it and other gastrointestinal tumors,and the diagnosis depends on immunohistochemistry and gene detection.CASE SUMMARY A 16-year-old man developed dizziness and fatigue 2 mo ago,and 10 d ago showed progressive exacerbation of paroxysmal epigastric pain and stopped flatulence and defecation.Computed tomography showed a soft tissue mass in the distal ileum.After complete resection of the lesion,it was diagnosed by combined immunohistochemical and genetic examination as CCSLGT.After surgery,the patient gradually developed lymph node,liver,lung,bone,left thigh,pleura and adrenal metastasis.The survival time was 4 years and 8 mo.CONCLUSION Whole abdominal computed tomography enhancement is recommended for patients with gastrointestinal symptoms.There is no effective treatment for CCSLGT with multiple metastases via the lymphatic system and bloodstream after surgical resection.
