A case of gastro-intestinal stromal tumor which had multiple liver metastases

まれな多発肝転移を伴った横行結腸原発のgastrointestinal stromal tumor(以下,GIST)の1例を経験したので報告する.症例は74歳の男性で下血を主訴に当院を受診した.大腸内視鏡検査で横行結腸に約9cmの粘膜下腫瘍様隆起を認め,CTで多発肝転移も認めた.右半結腸切除を施行し病理組織学的検索で紡錘形細胞が線維性増殖をしており, 腫瘍細胞は柵状配列を呈していた.c-kit,Desmin,SMAはともに陰性でS-100はごく少数陽性ではあったが,病理組織学的所見での腫瘍の柵状配列を重視してGISTと診断した.術後イマチニブを投与して経過良好である.

We report a case of a rare gastrointestinal stromal tumor(GIST)of the transverse colon with multiple liver metastases. A 74 years old man was hospitalized in emergency because of revealing melena. 9cm diameter mass in the transverse colon was found in colonoscopy and also multiple liver metastasis in CT. The patient underwent right hemicolectomy under the diagnosis of submucosal tumor. Histopathological findings showed the fascicular growth of spindle cells, and tumor cells presented palisading formation. Even though immunohistochemical examination showed tumor cell to be only a few positive for S-100, negative for c-Kit, nor Desmin, nor SMA, we diagnosed the case as GIST due to presenting histological palisading. We administered imatinib therapy after the surgery and the patient is doing well at this time.

gastrointestinal stromal tumor(GIST)

gastrointestinal mesenchymal tumor(GIMT)

神経原性腫瘍