GIANT EXTRAGASTROINTESTINAL TUMOR IN GYNECOLOGICAL PRACTICE


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Resumo

Background. The urgency of the problem lies in the complexity of the diagnosis of giant extra-organ neoplasms of the pelvis and abdominal cavity, as well as in the fact that a giant extragastrointestinal tumor is an extremely rare abnormality. Case report. The paper describes a clinical case of a rare form of a giant extra gastrointestinal tumor in a 62-year-old patient who had a large MSCT and MRI neoplasm probably originating from the ovary. An irregularly shaped tumor was intraoperatively found, which occupies the entire abdominal cavity and pelvis, measures 25x20x15 cm, has predominantly a solid structure with multiple cavity inclusions, and necrotic areas. The tumor had adhesions to the omentum, with loops of the small intestine at 60 cm above the ileocecal angle, and also to the bladder peritoneum. The vascular bundles supplying the tumor were visualized in the adhesions. It was impossible to identify the organ belonging of a tumor. The final diagnosis was based on the morphological and immunohistochemical diagnosis of gastrointestinal stromal tumor; spindle-cell structure. Conclusion. The differential diagnosis of large neoplasms localized in the pelvis is an important clinical task in the context of not only preventing possible complications that require emergency medical care by qualified specialists, but also assessing the risk of the malignant process and possible localization of the tumor in the adjacent organs, which necessitate the proper routing of the patient and the determination of the possibilities of a multidisciplinary approach.

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Sobre autores

Vitaly Bezhenar

Academician I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia

Email: bez-vitaly@yandex.ru
Dr. Med. Sci., Professor, Head of the Departments of Obstetrics, Gynecology and Neonatology and Reproductology, Head of the Clinic of Obstetrics and Gynecology; Main supernumerary specialist obstetrician-gynecologist 197022, Russia, St. Petersburg, Lva Tolstogo str., 6-8

Margarita Rybakova

Academician I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia

Dr. Med. Sci., Professor, Head of the Department of Pathological Anatomy 197022, Russia, St. Petersburg, Lva Tolstogo str., 6-8

Buzand Arakelyan

Academician I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia

Email: byuzand@mail.ru
Dr. Med. Sci., docent, Deputy Head of the Clinic of Obstetrics and Gynecology, Professor of the Department of Obstetrics, Gynecology and Neonatology 197022, Russia, St. Petersburg, Lva Tolstogo str., 6-8

Natalya Kuzmina

Academician I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia

Email: dok.kuzmina@gmail.com
Cand. Med. Sci., Head of the Oncology Department No. 7, Assistant of the Department of Obstetrics, Gynecology and Neonatology 197022, Russia, St. Petersburg, Lva Tolstogo str., 6-8

Gelfiya Nutfullina

Academician I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia

Cand. Med. Sci., Assistant of the Department of Pathological Anatomy 197022, Russia, St. Petersburg, Lva Tolstogo str., 6-8

Irina Medvedeva

Academician I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia

Email: iriskal8.05@mail.ru
obstetrician-gynecologist, Oncology Department No. 7 of the Clinic of Obstetrics and Gynecology 197022, Russia, St. Petersburg, Lva Tolstogo str., 6-8

Maria Morozova

Academician I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia

Email: mmorozova94@mail.ru
resident of the Clinic of Obstetrics and Gynecology 197022, Russia, St. Petersburg, Lva Tolstogo str., 6-8

Bibliografia

  1. Шакиров Р.Р., Зиганшин М.И., Карпухин О.Ю. Гигантская гастроинтестинальная стромальная опухоль сигмовидной кишки (клинический случай). Колопроктология. 2019; 18(4): 134-8.
  2. Poveda A., del Muro X.G., Lopez-Guerrero J.A., Martinez V., Romero I., Valverde C. et al. GEIS 2013 guidelines for gastrointestinal sarcomas (GIST). Cancer Chemother. Pharmacol. 2014; 74(5): 883-98. https://dx.doi. org/10.1007/s00280-014-2547-0.
  3. Пищик В.Г., Зинченко Е.И., Воробьев С.Л., Кораблина И.М. Редкая локализация гигантской гастроинтестинальной стромальной опухоли желудка в заднем средостении. Медицинский альянс. 2018; 4: 49-56. ESMO/European Sarcoma Network Working Group. Gastrointestinal stromal tumors: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann. Oncol. 2014; 25(Suppl. 3): iii21-6. https://dx.doi.org/10.1093/annonc/ mdu255.
  4. Park C.H., Kim E.H., Jung D.H., Chung H., Park J.C., Shin S.K. et al. Impact of periodic endoscopy on incidentally diagnosed gastric gastrointestinal stromal tumors: findings in surgically resected and confirmed lesions. Ann. Surg. Oncol. 2015; 22(9): 2933-9. https://dx.doi.org/10.1245/s10434-015-4517-0.
  5. Стромальные опухоли желудочно-кишечного тракта (GIST). Клиническая монография. Тверь: Триада; 2006. 40 с.
  6. Miettinen M, Lasota J. Gastrointestinal stromal tumors - definition, clinical, histological, immunohistochemical and molecular genetic features and diff erential diagnosis. Virchows Arch. 2001; 438(1): 1-12.
  7. Чиссов В.И., Давыдов М.И., ред. Онкология. Национальное руководство. Краткое издание. М.: ГЭ ОТАР-Медиа; 2014. 576 с.
  8. Кригер А.Г., Старков Ю.Г., Кармазановский Г.Г., Берелавичус С.В., Горин Д.С., Солодкий А.В., Ветшева Н.Н., Курушкина Н.А. Диагностика и тактика хирургического лечения гастроинтестинальной стромальной опухоли. Хирургия. Журнал им. Н.И. Пирогова. 2014; 1: 15-20.10.
  9. Маландин А.Г., Меркулов И.А., Иванов Ю.В., Пастухов А.И. Гастроинтестинальные стромальные опухоли (GIST): особенности диагностики и лечения. Хирургия. Журнал им. Н.И. Пирогова. 2012; 3: 32-41.11.
  10. Дубова Е.А., Щеголев А.И., Мишнев О.Д., Кармазановский Г.Г. Гастроинтестинальные стромальные опухоли (лекция). Медицинская визуализация. 2007; 1: 25-31.
  11. Егоров В.И., Кармазановский Г.Г., Щеголев В.А., Дубова Е.А., Яшина Н.И., Осипова Н.Ю., Степанова Ю.А., Солодинина Е.Н. Значение предоперационной визуализации для выбора хирургической тактики при гастроинтестинальных стромальных опухолях двенадцатиперстной кишки. Медицинская визуализация. 2007; 2: 34-43.
  12. Егоров В.И., Кубышкин В.А., Вишневский В.А., Щеголев А.И., Кармазановский Г.Г., Яшина Н.И., Степанова Ю.А., Солодинина Е.Н., Дубова Е.А. Гастроинтестинальные стромальные опухоли двенадцатиперстной кишки. Хирургия. Журнал им. Н.И. Пирогова. 2007; 10: 66-72.

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