Transperineal core-needle biopsy of a rectal subepithelial lesion guided by endorectal ultrasound after contrast-enhanced ultrasound: A case report

作     者：Qiong Zhang Jie-Ying Zhao Hua Zhuang Chun-Yan Lu Jin Yao Yuan Luo Yong-Yang Yu 

作者机构：Department of Diagnostic UltrasoundWest China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of RadiologyWest China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina Department of GastroenterologyWest China HospitalSichuan UniversityChengdu 610041Sichuan ProvinceChina 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2021年第27卷第13期

页      面：1354-1361页

核心收录：

学科分类：0831[工学-生物医学工程（可授工学、理学、医学学位）] 100207[医学-影像医学与核医学] 1002[医学-临床医学] 08[工学] 1010[医学-医学技术（可授医学、理学学位）] 100214[医学-肿瘤学] 10[医学] 

基　　金：Supported by National Natural Science Foundation of China,No. 81101061 Sichuan Science and Technology Planning Project,China,No. 2017JY0074 

主　　题：Transperineal core needle biopsy Endorectal ultrasound Contrast-enhanced ultrasound Rectal subepithelial lesion Case report 

摘      要：BACKGROUND Rectal subepithelial lesions(SELs) are commonly seen in endoscopic examination, generally manifested as bumps with a smooth surface. Precise preoperative diagnoses for rectal SELs are difficult because abnormal tissues are not easily to be obtained by regular endoscopic forceps biopsy. Traditional guidance modalities of preoperative biopsy, including endoscopic ultrasound, computed tomography, and transabdominal ultrasound, are often unsatisfactory. An updated, safe, and effective biopsy guidance method is required. We herein report a new biopsy guidance modality—endorectal ultrasound(ERUS) combined with contrastenhanced ultrasound(CEUS).CASE SUMMARY A 32-year-old woman complained of a mass inside the rectovaginal space for 9 years, which became enlarged within 1 year. A rectal SEL detected by endoscopy was suspected to be a gastrointestinal stromal tumor or exophytic uterine fibroid. Pathological diagnosis was difficult because of unsuccessful transabdominal core needle biopsy with insufficient tissues, as well as vaginal hemorrhage. A second biopsy was suggested after multiple disciplinary treatment discussion, which referred to a transperineal core needle biopsy(CNB) guided by ERUS combined with CEUS. Adequate samples were procured and rectal gastrointestinal stromal tumor was proved to be the pathological diagnosis. Imatinib was recommended for first-line therapy by multiple disciplinary treatment discussion. After the tumor shrunk, resection of the rectal gastrointestinal stromal tumor was performed through the posterior vaginal wall. Adjuvant therapy was applied and no recurrence or metastasis has been found by the last follow-up on December 13, *** Transperineal CNB guided by ERUS and CEUS is a safe and effective preoperative biopsy of rectal SELs yet with some limitations.