The Korean Journal of Medicine

  • 제80권2호
  • /
  • Pages.203-207
  • /
  • 2011
  • /
  • 1738-9364(pISSN)
  • /
  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
권호 표지

거대한 간 종괴로 재발한 저 위험도 위장관 간질 종양 1예

A Case of Huge Hepatic Recurrence of Low Risk Gastrointestinal Stromal Tumor

  • 허태윤 (가톨릭대학교 의과대학 대전성모병원 내과) ;
  • 안영용 (가톨릭대학교 의과대학 대전성모병원 내과) ;
  • 이정화 (가톨릭대학교 의과대학 대전성모병원 내과) ;
  • 이승우 (가톨릭대학교 의과대학 대전성모병원 내과) ;
  • 김연수 (가톨릭대학교 의과대학 대전성모병원 내과) ;
  • 강상범 (가톨릭대학교 의과대학 대전성모병원 내과) ;
  • 이동수 (가톨릭대학교 의과대학 대전성모병원 내과)
  • Heo, Tae-Yun (Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Ahn, Young-Yong (Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Lee, Jung-Hwa (Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Lee, Seung-Woo (Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Kim, Yeon-Soo (Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Kang, Sang-Bum (Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Lee, Dong-Soo (Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea College of Medicine)
  • 발행 : 2011.02.01
⟨ 이전 논문 다음 논문 ⟩

초록

위장관 간질종양(GIST)은 저 위험군의 경우 재발은 극히 드물다고 알려져 있다. 저자들은 8년 전 위의 저 위험도 간질종양을 진단받고 근치적 절제술을 시행받은 환자에서 간우엽 전체를 차지하는 거대한 간 종괴로 내원하여 간에 국한된 위장관 간질 종양의 재발을 진단하였기에 문헌고찰과 함께 보고하고자 한다. 이와 같은 위장관 간질 종양의 재발 환자는 그 예후가 좋지 않기 때문에 첫 진단 당시 저위험군 환자라 하더라도 근치적 절제술 후 지속적인 추적관찰을 필요로 한다.

Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors that express c-kit. The majority of GISTs are located in the stomach and small intestine. The tumors are classified into very-low-risk, low-risk, intermediate-risk, and high-risk categories based on size and mitosis activity. The recurrence of low-risk GIST is extremely rare. We report a hepatic recurrence of a low-risk gastric GIST that had been removed completely 8 years earlier, and presented as a huge hepatic mass. Since recurrent GIST has a poor prognosis, regular long-term follow-up must be considered, although the primary GIST was low risk.

키워드

참고문헌

  1. Shinomura Y, Kinoshita K, Tsutsui S, Hirota S. Pathophysiology, diagnosis, and treatment of gastrointestinal stromal tumors. J Gastoenterol 2005;40:775-780. https://doi.org/10.1007/s00535-005-1674-0
  2. Hsu KH, Yang TM, Shan YS, Lin PW. Tumor size is a major determinant of recurrence in patients with resectable gastrointestinal stromal tumor. Am J Surg 2007;194:148-152. https://doi.org/10.1016/j.amjsurg.2006.10.033
  3. Nilsson B, Bumming P, Meis-Kindblom JM, et al. Gastrointestinal stromal tumors: the incidence, prevalence, clinical course, and prognostication in the preimatinib mesylate era-a populationbased study in western Sweden. Cancer 2005;103:821-829. https://doi.org/10.1002/cncr.20862
  4. Mazur MT, Clark HB. Gastric stromal tumors: reappraisal of histogenesis. Am J Surg Pathol 1983;7:507-519. https://doi.org/10.1097/00000478-198309000-00001
  5. Fletcher CD, Berman JJ, Corless C, et al. Diagnosis of gastrointestinal stromal tumor: A concensus approach. Hum Pathol 2002;33:459-465. https://doi.org/10.1053/hupa.2002.123545
  6. Miettinen M, Kopczynski J, Makhlouf HR, et al. Gastrointestinal stromal tumor, intramural leiomyomas, and leiomyosarcomas in the duodenum: a clinicopathologic, immunohistochemical, and molecular genetic study of 167 cases. Am J Surg Pathol 2003;27:625-641. https://doi.org/10.1097/00000478-200305000-00006
  7. Hirota S, Isozaki K, Moriyama Y, et al. Gain of function mutation of c-kit in human gastrointestinal stromal tumors. Science 1998;279:577-580. https://doi.org/10.1126/science.279.5350.577
  8. Kazerooni EA, Quint LE, Francis IR. Duodenal neoplasm: predictive value of CT for determining malignancy and tumor resectablility. AJR Am J Roentgenol 1992;159:303-309. https://doi.org/10.2214/ajr.159.2.1632344
  9. DeMatteo RP, Lewis JJ, Leung D, Mudan SS, Woodruff JM, Brennan MF. Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival. Ann Surg 2000;231:51-58. https://doi.org/10.1097/00000658-200001000-00008
  10. Connolly EM, Gaffney E, Reynolds JV. Gastrointestinal stromal tumors. Br J Surg 2003;90:1178-1186. https://doi.org/10.1002/bjs.4352
  11. Pidhorecky I, Cheney RT, Kraybill WG, Gibbs JF. Gastrointestinal stromal tumors: current diagnosis, biologic behavior, and management. Ann Surg Oncol 2000;7:705-712. https://doi.org/10.1007/s10434-000-0705-6
  12. Amin MB, Ma CK, Linden MD, Kubus JJ, Zarbo RJ. Prognostic value of proliferating cell nuclear antigen index in gastric stromal tumor: correlation with mitotic count and clinical outcome. Am J Clin Pathol 1993;100:428-432. https://doi.org/10.1093/ajcp/100.4.428
  13. Duffaud F, Blay JY. Gastrointestinal stromal tumors: biology and treatment. Oncology 2003;65:187-197. https://doi.org/10.1159/000074470
  14. Steigen SE, Eide TJ. Gastrointestinal stromal tumors (GISTs): a review. APMIS 2009;117:73-86. https://doi.org/10.1111/j.1600-0463.2008.00020.x