위 누공 및 위 장관 출혈을 동반한 위의 위장관 기질종양 1예
A Case of a Gastric Gastrointestinal Stromal Tumor with a Fistula and Gastrointestinal Bleeding
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초록
위장관기질 종양은 그 기원이나 분화 및 예후에 있어 지속적 논란이 있어 왔던 종양이며, 최근의 여러 연구들은 c-kit 원발암 유전자 돌연변이의 발견으로 이들의 기원이 Cajal 간질세포로 추정케 하였다. 흔한 증상으로는 복통, 출혈, 종물의 촉지 등이 있으나, 종괴 내 농양을 동반한 채 위강과 교통하는 누공을 형성한 경우는 소수에서만 보고되었다. 전신쇠약감 및 발열을 주소로 내원한 84세 남자에서 상부위장관내시경, 전산화단층 촬영, 조직 및 면역조직화학 검사를 통해 중심부 누공을 통해 위강과 교통하는 광범위 괴사를 동반한 거대 위장관기질 종양을 진단하였기에 국내외 문헌고찰과 함께 보고하는 바이다.
Abstract
There has been much debate on the origin, differentiation and prognosis of gastrointestinal stromal tumors (GIST). Based on recent studies, we consider Cajal interstitial cell as the origin of a GIST. The common symptoms of a GIST are abdominal pain, hemorrhage, and the presence of a mass. However, there are few reported cases of a GIST with abscess pockets that communicate with the lumen of the stomach via a fistula. We report a case of a GIST of the stomach presenting with an abscess and a fistula communicating with the lumen of the stomach. An 84-year-old man presented with continuous fever and general weakness. We were able to diagnose the disease by an endoscopic examination, CT scan, biopsy and by cellular immunohistochemical staining. (Korean J Gastrointest Endosc 2007;35:337-341)
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