tailieunhanh - Báo cáo khoa học: "Malignant gastrointestinal stromal tumor presenting with hemoperitoneum in puerperium: report of a case with review of the literature"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Malignant gastrointestinal stromal tumor presenting with hemoperitoneum in puerperium: report of a case with review of the literature | Varras et al. World Journal of Surgical Oncology 2010 8 95 http content 8 1 95 WORLD JOURNAL OF SURGICAL ONCOLOGY CASE REPORT Open Access Malignant gastrointestinal stromal tumor presenting with hemoperitoneum in puerperium report of a case with review of the literature rrs c 1i l i I . I c l ladssbcsc2 ilrsc Abri ic3 Thi i acilabalã4 Px annolia CI nFialn4 Mliciiail Valias INlkolaos Vlachakos CMIIslUUOUlOs Akrivis llllvl vasilakakl Lvangelia Skaflda Abstract Background Gastrointestinal stromal tumors GISTs are mesenchymal tumors that develop in the wall of the gastrointestinal tract and thelr dlagnosls durlng pregnancy or puerperlum is extremely rare. Case A 28-year old patient presented with acute abdomen due to hemoperitoneum from a large mass arising of the small intestine with distended vessels on its top and a ruptured superficial vessel bleeding into the peritoneal cavity. The patient was at the tenth postpartum day of her first pregnancy. The preoperative diagnosis was a possible ovarian or uterine mass. After an emergency exploratory laparotomy a segmental bowel resection was performed removing the tumor with a part of 3-cm of the small intestine. Histology revealed GIST with maximum diameter of 13 cm and mitotic rates more than 5 mitoses per 50 high power fields with some atypical forms indicating a high risk malignancy. Immunohistochemical staining of the tumor tissue demonstrated strongly positive reactivity to CD 117 c-kit and CD34 in almost all the tumor cells. The patient was treated with oral imatinib mesylate Gleevec 400 mg daily for one year. Three years after surgery the patient was alive without evidence of metastases or local recurrence. Conclusion Considering that only few patients with gastrointestinal stromal tumors have been reported in the obstetrical and gynecological literature the awareness of such an entity by the obstetricians-gynecologists is necessary in order to facilitate coordinated approach with the general surgeons