Robotic wedge resection of a rare gastric perivascular epithelioid cell tumor: A case report

作     者：Alessandra Marano Francesca Maione Yanghee Woo Luca Pellegrino Paolo Geretto Diego Sasia Mirella Fortunato Giulio Fraternali Orcioni Roberto Priotto Renato Fasoli Felice Borghi 

作者机构：Department of SurgeryGeneral and Oncologic Surgery UnitSanta Croce e Carle HospitalCuneo 12100Italy Department of SurgeryCity of HopeDuarteCA 91010United States Department of PathologySanta Croce e Carle HospitalCuneo 12100Italy Department of RadiologySanta Croce e Carle HospitalCuneo 12100Italy Department of Gastroenterology and Digestive EndoscopySanta Croce e Carle HospitalCuneo 12100Italy 

出 版 物：《World Journal of Clinical Cases》 (世界临床病例杂志)

年 卷 期：2019年第7卷第23期

页      面：4011-4019页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Perivascular epithelioid cell tumor Stomach Robotic Surgery Minimally invasive Case report 

摘      要：BACKGROUND Perivascular epithelioid cell tumor(PEComa) is a rare mesenchymal neoplasm that can arise in many different organs with a broad spectrum of biological behavior, from indolent to aggressive progression. Only ten cases of gastric PEComas have been reported in the English literature, which were treated with endoscopic, laparoscopic, or open resections. Due to its rarity, the optimal surgical management and prognosis of this tumor are still *** SUMMARY We present a case of robotic wedge resection of a 6.5 cm bleeding lesion of the gastric fundus located 3 cm below the esophago-gastric junction in a 55-year-old man. Biopsy revealed a malignant tumor with epithelioid cells focally positive for muscle markers desmin and smooth muscle actin. In addition, histology revealed that the tumor was positive for HMB-45, melan-A(MART-1), microphthalmia transcription factor and negative for pan-cytokeratin AE1/AE3, CD34, p40, DOG-1, CD117(c-kit), S100, CD3, CD79 a, caldesmon and myogenin. These markers suggested the possibility of a PEComa. The patient underwent a diagnostic laparoscopy via the da Vinci? Si? system and robotic wedge resection. Final pathology confirmed a malignant gastric PEComa with negative margins. At his 11-mo follow-up visit, the patient remained *** Gastric PEComa can be treated with a robotic R0 resection with acceptable postoperative and short-term oncological outcomes.