胃瘤:内镜超声波和共享决策的作用
Alexander Malik1, Muhammad Nadeem Yousaf2, Sami Samiullah3
1Department of Medicine, Summa Health System, Akron, OH, USA.
Case reports in gastroenterology
|December 11, 2023
概括
胃瘤 (GGTs) 是一种罕见的胃瘤. 对于无症状的GGT患者,特别是老年患者,用成像和内镜超声波 (EUS) 监测可能是手术的合理替代方案.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 病理学 病理学 病理学
背景情况:
- 胃囊瘤 (GGTs) 是源自胃的亚皮质层的惰性介质瘤,占胃瘤的高达1%.
- 在食道胃二透镜 (EGD) 过程中,经常偶然发现GGT.
- 内镜超声波 (EUS) 对于诊断GGT和将其与其他胃瘤 (如GIST或神经内分泌瘤) 区分开来至关重要.
研究的目的:
- 评估EUS在识别胃瘤中的诊断效用.
- 讨论偶然检测到的胃瘤的管理策略,特别是老年患者.
- 探索监测作为一种潜在的替代手术切除无症状GGTs.
主要方法:
- 病例报告:一名80岁的男性出现腹部不适,并偶然发现了胃内腔结节.
- 诊断工作包括食管胃管腺镜 (EGD),内镜超声波 (EUS) 和细针活检的免疫组织化学染色.
- 评估诊断结果,并根据患者的年龄,症状和瘤特征考虑治疗选择.
主要成果:
- EGD显示出一个亚皮质病变,EUS证实为1.6厘米的异声波,带有化的均病变.
- 免疫组织化学证实了与GGT一致的瘤细胞.
- 患者的症状得到缓解,由于年龄较大和手术候选,选择了监视而不是切除.
结论:
- EUS对于准确评估和诊断胃囊瘤至关重要.
- 目前的指导方针缺乏监测无症状个体中偶然检测到的GGT的建议.
- 对于无症状的GGT患者或症状已消失的患者,特别是那些手术候选度较低的老年人,用连续成像和EUS进行仔细监测可能是合理的管理选择.
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