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vol.66 número5DISECCIÓN ESPONTÁNEA DE ARTERIA MESENTÉRICA SUPERIORHEMOTÓRAX ESPONTÁNEO EN PACIENTE CON SCHWANNOMA DE MEDIASTINO índice de autoresíndice de materiabúsqueda de artículos
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Revista chilena de cirugía

versión On-line ISSN 0718-4026

Resumen

BELTRAN S, Marcelo A et al. Simultaneous surgical management of a patient with distal pancreatic cancer, gastric gastrointestinal tumors (GIST) and hepatic hemangioma. Rev Chil Cir [online]. 2014, vol.66, n.5, pp.478-482. ISSN 0718-4026.  http://dx.doi.org/10.4067/S0718-40262014000500013.

Introduction: The occurrence of gastric Gastrointestinal Stromal Tumors (GIST) associated to pancreatic adenocarcinoma has been reported in 0.2% pancreatic cancers. There are no published reports on distal pancreatic adenocarcinoma associated to gastric antral GIST and the surgical management of this clinical condition. Case report: Herein, we discuss a 75 years-old female patient who was admitted to our institution with upper digestive hemorrhage. The endoscopy showed large, superficial erosions over the cardia and on the posterior wall of the antrum a rounded sub-mucosal non-eroded lesion suspected of gastric GIST. An abdominal computed tomography scan found a hepatic hemangioma on the left hepatic lobe. In the pancreatic distal body and tail a solid exophytic lesion was identified. In the gastric antrum a rounded submucosal tumor in close contact with the pancreatic lesion was found. The patient was subjected to distal pancreatectomy, splenectomy, and distal gastrectomy. The biopsy identified a well-differentiated ductal adenocarcinoma localized in the pancreatic tail and the proximal part of the body, resected with negative margins. The gastric tumor was positive for CD117, CD34, and DOG-1; it had a positive Ki67 in less than 2%, and 2 or less mitoses per 50 high-power fields. Conclusion. This uncommon case illustrates the occurrence of synchronous tumors of different cellular origins incidentally diagnosed and their simultaneous surgical treatment. The individual incidence of these tumors is low and if associated they probably will continue to be found incidentally.

Palabras clave : Gastrointestinal Stromal Tumors; GIST; pancreatic cancer; hepatic hemangioma.

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