대장 샘암종과 동시에 발생한 위장의 위장관 간질종양
Synchronous Incidental Occurrence of Gastric Gastrointestinal Stromal Tumor and Colon Adenocarcinoma
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위장관 간질종양과 함께 동시에 위암, 대장암, 췌장암, 신장암과 유암종 같은 악성 종양이 발생하는 것으로 보고하고 있지만, 현재까지는 제한된 증례 보고이고 관련된 기전이나 원인에 대해서는 거의 알려진 것이 없다. 이번 증례는 62세 남자가 전신 무력감과 간헐적인 혈변을 주소로 내원하여 대장내시경을 실시하였고, 우측 상행결장에서 궤양성 종괴가 관찰되었다. 조직 검사에서 샘암종으로 진단되어 병기 결정을 위한 복부 전산화단층촬영과 양전자방출촬영을 실시였고, 우연히 위장의 분문부에 4 cm 크기에 점막하 종괴가 관찰되었다. 복강경을 이용한 우측 결장절제술을 실시하였고, 동시에 복강경 보조의 전위절제술과 림프절 곽청술을 실시하였다. 수술 후 조직 검사에서 CD117와 CD34가 양성인 위장관 간질종양으로 진단되어 대장 샘암종과 동시에 발생한 위장관 간질종양에 대해 문헌 고찰과 함께 보고한다.
Abstract
A few cases of gastrointestinal stromal tumor (GIST) synchronous cancers with other malignancies have been reported, such as gastric cancer, pancreatic cancer, renal cell carcinoma, colon cancer, and carcinoid tumor. However, little is known about their coincidence with other tumors with a different histogenesis. A 62-year-old man visited our hospital with generalized weakness and intermittent hematochezia. A colonoscopic examination showed an ulcerating mass in the ascending colon, and a biopsy specimen revealed adenocarcinoma. A lobulated submucosal mass in the gastric fundus was found incidentally during the preoperative staging procedures, including computed tomography (CT) and positron emission tomography-CT. The colon cancer and gastric tumor were removed simultaneously (laparoscopy assisted right hemicolectomy and total gastrectomy). Immunohistochemical studies on the gastric tumor surgical specimen showed that it was CD117 (+) and CD34 (+), and the final diagnosis was a GIST of the stomach. Herein, we report a case of the synchronous occurrence of colon adenocarcinoma and gastric GIST.
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