Gebelikte gastrik stromal tümör: Olgu sunumu

Öz

Gastrointestinal stromal tümörler (GIST) gastrointestinal sistemi duvarında gelişen nadir mezenkimal tümörlerdir. Gebelikte GIST ile ilgili literatürde az miktarda bilgi bulunmaktadır. Biz burada gebelik ikinci trimesterde tespit edilen bir GIST olgusunu rapor ediyoruz. Olgu 44 yaşında ve hamileliğin beşinci ayındaydı. Biliyer kolik ağrısı ile başvurdu. Abdominal muayenede 15 cm'lik rahim yüksekliği ve sağ hypochondrium 15 cm kitle tespit edildi. Abdominal ultrasonografi ve manyetik rezonans görüntüleme ile sağ hypochondrium bölgesinde büyük bir lezyon gösterildi. Endoskopi ile midenin önünde dışsal bası görüldü. Hasta ameliyata alındı ve orta hat kesi yapıldı. Eksplorasyonda neredeyse tüm sağ hypochondrium işgal eden, karaciğeri yukarı ve rahimi aşağı iten, küçük kurvatür düzeyinde mideye yapışan, yaklaşık 3 cm'lik bir implantasyon tabanı olan 25 cm kitle tespit edildi. Histolojik ve immun histokimyasal çalışmalar, yüksek malignite riskli GIST gösterdi. Literatürde gebelik sırasında sadece olgu sunumu olarak bildirilen GIST, multidisipliner bakım gerektiren nadir bir patolojidir.

Anahtar Kelimeler

• Hamilelik,Gestasyon,Imatinib,Gastrointestinal stromal tümör

Gastric stromal tumor with pregnancy: A case report

Abstract

Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors that develop in the wall of the gastrointestinal tract. There is few given information throughout literature concerning gestation associated with GIST. We report here the case of a patient who was admitted in our hospital for GIST discovered during the second trimester of pregnancy. She was 44 years old, in the fifth months of pregnancy. She was admitted for biliary colic pain. An abdominal examination objectified a distended abdomen with uterine height of 15 cm and right hypochondrium mass of 15 cm. Abdominal ultrasound and magnetic resonance imaging showed a large lesion process in the right hypochondrium region. Endoscopy objectified an aspect of extrinsic compression at the front of the stomach. The patient was operated and an umbilical median incision was performed, exploration showed the presence of a hug mass measuring 25 cm occupying almost all of the right hypochondrium, pushing the liver up and the uterus down, adheres to the stomach at the level of the small curvature with an implantation base of about 3 cm. Histological and immune histochemical study of hepatic process showed a GIST of high risk of malignancy. Only some cases have been reported in the literature on GIST during pregnancy showing the rarity of the pathology that requires multidisciplinary care.

Keywords

• Pregnancy,Gestation,Imatinib,Gastrointestinal stromal tumor

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