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Maligner gastrointestinaler Stromatumor (GIST) der Papilla vateri

Eine seltene Tumorentität

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Zusammenfassung

Wir berichten über eine 68-jährige Patientin, die uns mit einem malignen gastrointestinalen Stromatumor der Papille zur Operation vorgestellt wurde. In der weiteren Umfelddiagnostik fiel ein Rundherd im VIII. Lebersegment auf, wobei es sich schnellschnitthistologisch um eine alte parasitäre Leberzyste handelte, so dass eine Duodenopankreatektomie unter kurativer Intention durchgeführt werden konnte. Der postoperative Verlauf gestaltete sich komplikationslos. Eine adjuvante Therapie wurde nicht angeschlossen. Die Therapie von GIST-Tumoren ist aufgrund der Heterogenität und in unserem Fall der sehr seltenen Lokalisation schwierig zu beurteilen. Wir haben uns an die onkologischen Prinzipien für Papillentumoren gehalten. Die Beschreibung eines GIST-Tumors der Papille haben wir in der uns zur Verfügung stehenden Literatur nicht gefunden.

Abstract

We present the case report of a 68-year-old female patient who had a malignant gastrointestinal stromal tumor of the papilla of Vater. The abdominal CT showed a coin-shaped lesion in the liver (segment VIII). Intraoperative rapid histological examination detected an old parasitic hepatic cyst. To exclude metastasis, we performed duodenopancreatectomy with curative intention. The postoperative course was without complications and neither chemotherapy nor other adjunct treatment was necessary. Because of heterogeneity, the different localization, and in this case the rare localization, surgery of gastrointestinal stromal tumors is difficult. However, we adhered to oncological and therapeutic standards of surgery for papillary carcinoma. This case is discussed based on a review of the literature. However, until now there has been no case report of gastrointestinal stromal tumor of the papilla of Vater in the literature.

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Wellmann, K., Gohla, G. & Wenk, H. Maligner gastrointestinaler Stromatumor (GIST) der Papilla vateri. Chirurg 75, 196–199 (2004). https://doi.org/10.1007/s00104-003-0737-0

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