RESUMO
Gastrointestinal stromal tumors (GIST) are lesions whose diagnosis and treatment have varied in the last decade. We report a 76 year-old male with a history of eight episodes of upper gastrointestinal bleeding. A duodenography showed an elevated lesion in the third portion of the duodenum with a central ulceration. It was initially managed with tumorectomy and primary closure of the duodenum. The pathological study of the surgical specimen revealed a low grade gastrointestinal stromal tumor. Three years later, the tumor recurred and pancreatoduodenectomy was performed. Due to the high risk of malignant potential, tumor size, number of mitoses and the presence of necrosis, imatinib mesylate was started. The patient had a satisfactory evolution, without evidences of recurrence after 15 months of follow up.
Assuntos
Neoplasias Duodenais , Tumores do Estroma Gastrointestinal , Idoso , Antineoplásicos/uso terapêutico , Benzamidas , Neoplasias Duodenais/tratamento farmacológico , Neoplasias Duodenais/patologia , Neoplasias Duodenais/cirurgia , Úlcera Duodenal/diagnóstico por imagem , Úlcera Duodenal/tratamento farmacológico , Úlcera Duodenal/cirurgia , Hemorragia Gastrointestinal/diagnóstico por imagem , Hemorragia Gastrointestinal/tratamento farmacológico , Hemorragia Gastrointestinal/cirurgia , Tumores do Estroma Gastrointestinal/tratamento farmacológico , Tumores do Estroma Gastrointestinal/patologia , Tumores do Estroma Gastrointestinal/cirurgia , Humanos , Mesilato de Imatinib , Masculino , Pancreaticoduodenectomia , Piperazinas/uso terapêutico , Proteínas Proto-Oncogênicas c-kit , Pirimidinas/uso terapêutico , Radiografia , RecidivaRESUMO
Gastrointestinal stromal tumors (GIST) are lesions whose diagnosis and treatment have varied in the last decade. We report a 76 year-old male with a history of eight episodes of upper gastrointestinal bleeding. A duodenography showed an elevated lesion in the third portion of the duodenum with a central ulceration. It was initially managed with tumorectomy and primary closure of the duodenum. The pathological study of the surgical specimen revealed a low grade gastrointestinal stromal tumor. Three years later, the tumor recurred and pancreatoduodenectomy was performed. Due to the high risk of malignant potential, tumor size, number of mitoses and the presence of necrosis, imatinib mesylate was started. The patient had a satisfactory evolution, without evidences of recurrence after 15 months of follow up.
Assuntos
Idoso , Humanos , Masculino , Neoplasias Duodenais , Tumores do Estroma Gastrointestinal , Antineoplásicos/uso terapêutico , Neoplasias Duodenais/tratamento farmacológico , Neoplasias Duodenais/patologia , Neoplasias Duodenais/cirurgia , Úlcera Duodenal/tratamento farmacológico , Úlcera Duodenal , Úlcera Duodenal/cirurgia , Hemorragia Gastrointestinal/tratamento farmacológico , Hemorragia Gastrointestinal , Hemorragia Gastrointestinal/cirurgia , Tumores do Estroma Gastrointestinal/tratamento farmacológico , Tumores do Estroma Gastrointestinal/patologia , Tumores do Estroma Gastrointestinal/cirurgia , Pancreaticoduodenectomia , Piperazinas/uso terapêutico , Proteínas Proto-Oncogênicas c-kit , Pirimidinas/uso terapêutico , RecidivaRESUMO
Se analizó retrospectivamente 50 pacientes operados por contusión abdominal complicada entre enero de 1983 y septiembre de 1987. La mortalidad de los pacientes mayores de 45 años fue de 35,7% en relación a 19,4% para los menores de esta edad. Los pacientes intervenidos entre las 3 y 6 horas de ingreso fueron los de menor mortalidad (13%). Los órganos abdominales más frecuentes lesionados fueron: bazo con 36%, e hígado con 24%. En 58% hubo lesión extraabdominal asociada, en ellos la mortalidad fue de 37,9% y de 4,75% en los sin asociación. La mortalidad global alcanzó 24%