膣後壁合併切除を伴う会陰アプローチが有用であった直腸巨大GISTの1切除例  [in Japanese] Giant rectal gastrointestinal stromal tumor successfully resected by abdominoperineal resection combined with posterior vaginal wall resection  [in Japanese]

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Author(s)

    • 岩川 和秀 Iwakawa Kazuhide
    • 国立病院機構福山医療センター 外科 Department of Surgery, National Hospital Organization Fukuyama Medical Center
    • 西江 学 Nishie Manabu
    • 国立病院機構福山医療センター 外科 Department of Surgery, National Hospital Organization Fukuyama Medical Center
    • 宮宗 秀明 Miyaso Hideaki
    • 国立病院機構福山医療センター 外科 Department of Surgery, National Hospital Organization Fukuyama Medical Center
    • 岩垣 博巳 Iwagaki Hiromi
    • 国立病院機構福山医療センター 外科 Department of Surgery, National Hospital Organization Fukuyama Medical Center

Abstract

   We report a case of giant rectal gastrointestinal stromal tumor (GIST) successfully resected by abdominoperineal resection combined with posterior vaginal wall resection. Our patient was a 79-year-old woman had been diagnosed as having von Recklinghausen disease at the age of 30 years. In 2006, a computed tomography (CT) scan revealed a tumor originating from the posterior wall of the rectum. In June 2010, she was admitted to our hospital with the chief complaint of bloody stool. A CT scan revealed a giant tumor that had increased to 9cm in size. Colonoscopy demonstrated a submucosal tumor, which was subsequently diagnosed by biopsy as a GIST. Due to the patient's continuous bleeding and abdominal pain, an emergent abdominoperineal resection was performed at that time. The tumor, which measured 8×9cm, was immunohistochemically positive for c-kit and CD34. Concomitant resection of the posterior wall of the vagina via the perineal approach provided a wide area to expose the tumor for a safe operation. The patient has been well with no sign of recurrence since the operation. This procedure is recommended as a useful approach for giant rectal GISTs or rectal cancer with invasion of the posterior pelvic wall.

   We report a case of giant rectal gastrointestinal stromal tumor (GIST) successfully resected by abdominoperineal resection combined with posterior vaginal wall resection. Our patient was a 79-year-old woman had been diagnosed as having von Recklinghausen disease at the age of 30 years. In 2006, a computed tomography (CT) scan revealed a tumor originating from the posterior wall of the rectum. In June 2010, she was admitted to our hospital with the chief complaint of bloody stool. A CT scan revealed a giant tumor that had increased to 9cm in size. Colonoscopy demonstrated a submucosal tumor, which was subsequently diagnosed by biopsy as a GIST. Due to the patient's continuous bleeding and abdominal pain, an emergent abdominoperineal resection was performed at that time. The tumor, which measured 8×9cm, was immunohistochemically positive for c-kit and CD34. Concomitant resection of the posterior wall of the vagina via the perineal approach provided a wide area to expose the tumor for a safe operation. The patient has been well with no sign of recurrence since the operation. This procedure is recommended as a useful approach for giant rectal GISTs or rectal cancer with invasion of the posterior pelvic wall.

Journal

  • Okayama Igakkai Zasshi (Journal of Okayama Medical Association)

    Okayama Igakkai Zasshi (Journal of Okayama Medical Association) 126(3), 217-221, 2014

    Okayama Medical Association

Codes

  • NII Article ID (NAID)
    130004903245
  • NII NACSIS-CAT ID (NCID)
    AN00032489
  • Text Lang
    JPN
  • Article Type
    Journal Article
  • Journal Type
    大学紀要
  • ISSN
    0030-1558
  • NDL Article ID
    025968658
  • NDL Call No.
    Z19-269
  • Data Source
    NDL  IR  J-STAGE 
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