RESUMO
The synchronous development of epithelial and stromal tumors of the digestive tract was rarely reported in the literature. Two such cases are described in this article. One is of a 44-year-old man presenting a high grade gastric stromal tumor associated with an adenocarcinoma of the large bowel. The other is of a 68-year-old man presenting an adenocarcinoma of the head of the pancreas associated with a low grade gastric stromal tumor. The hypothesis that the association is due to a simple coincidence particularly in areas with high rates of digestive cancer is proposed. A possibility of a genetic mutation or a single carcinogenic agent interacting with two tissues in the digestive tract and inducing the development of tumors of different histotype cannot be discarded.
Assuntos
Adenocarcinoma , Neoplasias do Colo , Tumores do Estroma Gastrointestinal , Neoplasias Primárias Múltiplas , Neoplasias Pancreáticas , Adenocarcinoma/diagnóstico , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Adulto , Colectomia , Colo/patologia , Neoplasias do Colo/diagnóstico , Neoplasias do Colo/patologia , Neoplasias do Colo/cirurgia , Colonoscopia , Tumores do Estroma Gastrointestinal/diagnóstico , Tumores do Estroma Gastrointestinal/patologia , Tumores do Estroma Gastrointestinal/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/diagnóstico , Neoplasias Primárias Múltiplas/patologia , Neoplasias Primárias Múltiplas/cirurgia , Pâncreas/patologia , Neoplasias Pancreáticas/diagnóstico , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/patologia , Neoplasias Pancreáticas/cirurgia , Radiografia Abdominal , Tomografia Computadorizada por Raios XRESUMO
Retroperitoneal schwannoma is a rare tumor originating in the neural sheath. We report the case of a 48 year-old women. She had a ten year history of lumbal pain. The abdominal sonography had revealed a left retroperitoneal tumor that compresses the left renal cavities. The abdominal CT scan visualized a 56 mm, homogenous, well demarcated, retroperitoneal mass with a low attenuation. This mass with multiple enhanced septa is separated from the left adrenal gland. The diagnosis of a cystic lymphangioma is made. We perform surgical exeresis of the tumor by a left lumbal laparotomy. The pathology examination concludes in an altered schwannoma with Antoni B patterns. Retroperitoneal schwannoma is a primary neural benign tumor with a good prognosis. The management is surgical.