Multifokales Siegelringzell-Adenokarzinom des Magens mit inzidentellem gastrointestinalem Stromatumor in einer Typ-B-Gastritis

Zusammenfassung

Ein 79-jähriger Patient wurde zur Abklärung einer mikrozytären hypochromen Anämie unter einer Marcumar-Therapie eingewiesen. Bei Verdacht auf eine gastrointestinale Blutung wurde eine Ösophagogastroduodenoskopie (ÖGD) durchgeführt, die ein großes multifokales, schlecht differenziertes Siegelringzell-Adenokarzinom des Magens (diffuser Typ nach Lauren) zeigte. Nach üblichen Staginguntersuchungen wurde eine D 2-Gastrektomie durchgeführt. Nach histologischer Aufarbeitung zeigten sich ein multifokales schlecht differenziertes Adenokarzinom mit einer Infiltration bis in die Submukosa (sog. Frühkarzinom vom Submukosatyp) und zufällig ein bis dahin nicht bekannter, 0,8 cm im Durchmesser großer gastrointestinaler Stromatumor (GIST). Nach Literaturdurchsicht dokumentierten wir hier erstmalig ein multifokales Siegelringzell-Adenokarzinom des Magens mit zusätzlichem GIST in einer Typ-B-Gastritis.

Abstract

A 79-year-old man was admitted because of anemia during marcumar therapy with suspected bleeding in the gastrointestinal tract. Endoscopy revealed a large mutifocal poorly differentiated gastric signet ring cell adenocarcinoma. After staging by the usual oesophagogastroduodenoscopic method, a total D 2 gastrectomy was performed. In the pathological resection specimen of the stomach, a multifocal poorly differentiated signet ring cell adenocarcinoma, infiltrating the submucosa (so called early cancer of sm-type) and an incidental gastroinstinal stromal tumour, 0.8 cm in diameter, was diagnosed. This is the first case report of the synchronous occurrence of a multifocal poorly differentiated gastric adenocarcinoma with signet-ring cell morphology (diffuse type according to the Lauren classification) and a GIST incidentally within a stomach with Hp-associated gastritis.

chronische gastrointestinale Blutung - gastrointestinaler Stromatumor (GIST) - Helicobacter pylori - Magenkarzinom

chronic gastrointestinal bleeding - gastrointestinal stromal tumour (GIST) - Helicobacter pylori - stomach cancer

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