Tumeurs stromales gastro-intestinales (GIST) multiples chez un malade atteint d'une maladie de Recklinghausen - 26/03/08
Olivier Guillaud [1],
Jérôme Dumortier [1],
Pierre-Paul Bringuier [2],
Jean-Christophe Saurin [1],
Gilles Poncet [1],
Jean Boulez [1],
Luc Henry [3],
Jean-Alain Chayvialle [1],
Jean-Yves Scoazec [2]
Voir les affiliationsMultiple gastro-intestinal stromal tumors (GIST) in a patient with type I neurofibromatosis revealed by chronic bleeding: pre-operative radiological diagnosis |
Recent studies have pointed out a high incidence of GIST, usually multiple and of small intestinal location, in patients with type I neurofibromatosis. We here report an additional case, revealed by chronic gastro-intestinal bleeding and diagnosed at pre-operative imaging studies. À 56-year-old patient, with known type I neurofibromatosis, was referred to our department for the exploration of chronic gastro-intestinal bleeding during anti-aggregant therapy. Endoscopical examination was negative. Enteroscanner showed the presence of four tumor lesions, 3 in the jejunum and 1 in the ileum. Segmental surgical resections were performed. At histological examination, 2 of among the 3 jejunal lesions were diagnosed as typical GIST, of low risk of malignancy, CD117+, CD34+, whereas the last jejunal and ileal lesions were identified as fibroid tumors. Mutations of c-kit gene and of the gene coding for PDGF-R were not detected. Post-operative recovery was uneventful; no recurrent bleeding was observed. Our case report underlines the potential role of enteroscanner in the management of patients with type I neurofibromatosis with possible digestive complications. It also emphasizes the importance of an accurate diagnosis of the digestive tumors associated with type I neurofibromatosis: GISTs are frequent in this setting and must not be misdiagnosed as neurofibromas.
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© 2006 Elsevier Masson SAS. Tous droits réservés.
Vol 30 - N° 2
P. 320-324 - février 2006 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.