華山論劍-專業案例挑戰/Case 2015-001

Date: 5 Apr. posted by 蔡英楠/曾兆明/陳志城/湯道謙/張吉仰/牟聯瑞醫師學術天地

Answer of Case 2015-001

Clinical Course:

She underwent exploratory laparotomy. During the operation, a 10cm tumor with adjacent jejuno-jejunal intussusception was noted at 80~90cm below ligament of Treitz. After transection of the lesion, end-to-end anastomosis was performed smoothly. Pathology showed ulceration and a submucosal tumor composed of spindle cells growing in short interlacing fascicles. Skenoid fibers are seen in the tumor. Immunohistochemical study CD117 was positive and mitotic rate:0/50 HPF.

Final Diagnosis:

Jejunal GIST with jejunojejunal intussusception with active bleeding, s/p segmental bowel resection with end-to-end anastomosis, moderate malignant potential