줄기를 형성한 위의 관외형 위장관간질종양 1예
A Case of a Pedunculated Exoluminal Gastrointestinal Stromal Tumor in the Stomach
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초록
위장관간질종양(gastrointestinal stromal tumor, GIST)은 위장관계의 원발 비상피성 종양 중 가장 흔하며 대부분 증상이 없어 우연히 발견되는 경우가 많다. 특히, 관외형 위장관 간질종양의 경우 일반적으로 많이 진행할 때까지 특별한 증상을 나타내지 않는 것으로 알려져 있다. 저자 등은 복부 종물 및 복부 팽만을 주소로 내원한 49세 남자 환자에서 줄기를 형성한 관외형 위장관 간질 종양을 진단하고 복강경 수술로 치료했던 1예를 경험하였으며 국내에서 보고된 예를 찾을 수 없었기에 이에 문헌 고찰과 함께 이를 보고한다.
Abstract
A 49-year-old man visited our hospital with a complaint of a left lower quadrant abdominal mass. Abdominal computed tomography (CT) showed an exophytic tumor attached to the stomach; the marginal region was intensely enhanced as seen on contrast imaging in the delayed phase. The gastric tumor was excised using a laparoscopic procedure. The gastric tumor was removed along with the gastric wall where the tumor was attached to by a pedicle. The external surface of the tumor showed a well-encapsulated appearance and several engorged vessels. Histologically, the tumor cells had a clear or eosinophilic cytoplasm and round nuclei. Four mitotic figures were seen per 50 cells on a high power field. Immunohistochemical staining demonstrated positive expression of c-kit, CD34, and vimentin and negative expression of smooth muscle actin (SMA) and S-100. The final diagnosis was a pedunculated exoluminal gastrointestinal stromal tumor (GIST). (Korean J Gastrointest Endosc 2007;35:332-336)
참고문헌 (15)
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