J Gastric Cancer.  2011 Mar;11(1):55-58.

Synchronous Adenocarcinoma and Gastrointestinal Stromal Tumor of the Stomach Treated by a Combination of Laparoscopy-assisted Distal Gastrectomy and Wedge Resection

• Jeong SH
• Lee YJ
• Park ST
• Choi SK
• Hong SC
• Jung EJ
• Ju YT
• Jeong CY
• Ha WS

Abstract

The simultaneous occurrence of a gastrointestinal stromal tumor (GIST) and a gastric adenocarcinoma is uncommon, and has rarely been reported in the literature. The present report describes the case of a 74-year-old male patient who initially presented with an adenocarcinoma that had invaded the antral mucosa. Computed tomography then revealed the presence of a suspected GIST, in the form of a 2x2 cm mass at the hilum of the spleen. In view of the advanced age of the patient, a surgical approach that would minimize risk and maximize quality of life was preferred. The patient therefore underwent simultaneous laparoscopy-assisted distal gastrectomy for the adenocarcinoma and wedge resection for the GIST. This approach was only chosen after confirming that it would be possible to preserve three or more of the short gastric arteries that supply the area below the wedge resection site. This may be considered a feasible approach to the management of the simultaneous occurrence of a mid-to-low gastric body adenocarcinoma and a high gastric body GIST.

Keyword

Gastrointestinal stromal tumors; Stomach neoplasms; Laparoscopy

MeSH Terms

Adenocarcinoma
Aged
Arteries
Carbamates
Gastrectomy
Gastrointestinal Stromal Tumors
Humans
Laparoscopy
Male
Mucous Membrane
Organometallic Compounds
Quality of Life
Spleen
Stomach
Stomach Neoplasms
Carbamates
Organometallic Compounds

Figure

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  Fig. 1 (A) Endoscopic image of the antral lesion. (B) Computed tomography revealed the presence of a suspected GIST, in the form of an approximately 2×2 cm mass (Arrow) at the hilum of the spleen. GIST = gastrointestinal stromal tumor.

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  Fig. 2 (A) The presence of the mass at the hilum of the spleen was confirmed intraoperatively (the short arrow indicates the SMT, and the long arrow indicates the short gastric artery, which could supply the remnant stomach). (B) The SMT was dissected laparoscopically. (C) Wedge resection of the GIST was performed. SMT = submucosal tumour; GIST = gastrointestinal stromal tumor.

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