복강 내 종양으로 오인된 미소 위유암종의 림프절 전이 1예
A case of a minute gastric carcinoid tumor with regional lymph node metastasis that was misdiagnosed as an intraabdominal mass
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초록
위유암종은 드문 질환으로 전체 원발성 위종양의 0.3%, 전체 유암종의 2% 이하로 알려져 있고, 대부분 무증상이다. 그러나 최근 들어 위내시경 검사의 시행이 빈번해지고 면역조직검사의 발달로 이들의 발견 빈도가 점차 증가하고 있는 추세이다. 위유암종은 크게 세 가지 형태로 분류되며, 산발적으로 발생하는 제3형의 경우 공격적인 임상상을 가지고 전이가 잘되는 것으로 알려져 있으나, 크기가 1.0 cm 이하인 미소 위유암종의 경우 일반적으로 전이는 극히 드물다. 저자 등은 연고지 병원에서 우연히 발견된 복강 내 종물을 주소로 내원한 42세 여자의 상부 위내시경 검사에서 약 0.8 cm 크기의 미소 위유암종을 발견하여 내시경적 절제술을 시행한 후 복강 내 종물에 대한 외과적 절제에서 이들이 위유암종의 림프절 전이로 확인된 1예를 경험하였기에 문헌고찰과 함께 보고한다.
Abstract
Gastric carcinoid tumors have been regarded as rare neoplasms, accounting for just 0.3% of all gastric tumors and fewer than 2% of all carcinoid tumors. Recently, there has been an increase in the number of reported studies of gastric carcinoid tumors with the widespread use of gastroscopy and improvements in immunohistochemical methods. Gastric carcinoid tumors are classified into three types. For type III gastric carcinoids not associated with hypergastrinemia, which tend to be larger and demonstrate a biologically more aggressive behavior with metastasis, and also for sporadic lesions, excision with regional lymph node clearance has been recommended. Tumors that are less than 1cm in size are called minute carcinoids, which seldom give rise to regional lymph node metastasis, except in rare cases. We report here a rare case of a minute gastric carcinoid tumor with regional lymph node metastasis that was misdiagnosed as an intraabdominal mass in a 42-year-old woman. Furthermore, we review the available literature on this entity.(Korean J Med 72:411-414, 2007)
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