Marco-Doménech SF, Sáez-Valero E, Lorenzo-Gorriz A, Fernández-García P, Navarro-Ballester A

Language: Spanish
References: 14
Page: 117-122
PDF size: 543.47 Kb.

ABSTRACT

We present what we believe to be the second case of a rectal gastrointestinal stromal tumor, diagnosed by thick needle transvaginal ultrasound-guided biopsy, after the first case presented by Takano et al. We want to confirm the usefulness of this access pathway to obtain biopsies of both the rectal gastrointestinal stromal tumor and other rectal or pelvic lesions. The case presented is a woman 58 years of age with a tumor measuring 3.5 cm on its longest axis depending from the anterior rectal wall, which produced dyspareunia. Given the radiological characteristics we included the gastrointestinal stromal tumor as differential diagnosis. The biopsy of the lesion was taken with a thick needle and transvaginal ultrasound guidance. We obtained two cylinders from the lesion, for which the anatomopathological result was gastrointestinal stromal tumor. Study of the piece confirmed the preoperative diagnosis. We conclude that, if the lesion can be seen with transvaginal ultrasound, preoperative transvaginal biopsy is a safe and simple technique; it is a valid alternative to diagnose rectal gastrointestinal stromal tumor and lesions from which biopsies cannot be taken by endoscopy.

REFERENCES

1. Miettinen M, MaaritSarlomo R. Gastrointestinal stromal tumors: value of CD in their identification and separation from true leioimyomas and schwanomas. Am J SurgPathol 1995;19:207-16.

2. Jamali F, Darwiche S, El-kinge A, Tawil A, Sowed A. Disease progression following imatinib failure in gastrointestinal stromal tumors: Role of surgical therapy. Oncologist 2007;12:438-442.

3. Marco-Doménech SF, Gil-Sánchez S, Fernandez-García P, et al. Sonographically guided percutaneous biopsy of gastrointestinal tract lesions. AJR 2001;176:147-51.

4. Giede C, Toi A, Chapman W, Rosen B. The use of transrectal ultrasound to biopsy pelvic masses in women. GynecolOncol 2004;95:552-56.

5. Panzironi G, Mannganaro L, Ricci F, Casale A, Macciucca M. A case of rectal GIST: findings of MR-spiral CT imaging and transrectal ultrasound guided biopsy. European Journal of Radiology 2003;47:66-69.

6. Boo SJ, Byeon JS, Park do H et al. EUS-guided fine needle aspiration and trucut needle biopsy for examination of rectal and perirectal lesions. Scandinavian Journal of Gastroenterology 2011;46:1510-1518.

7. De Witt J, Emerson RE, Sherman S et al. Endoscopic ultrasound-guided Trucut biopsy of gastrointestinal mesenchymal tumor. Surg Endosc 2011;25:2192-2202.

8. Takano M, Saito K, Kita T, Furuya K, Aida S, Kikuchi Y. Preoperative needle biopsy and inmunohistochemical analysis for gastrointestinal stromal tumor of the rectum mimicking vaginal leiomyoma. Int J Gynecol Cancer 2006;16:927-30.

9. Fletcher CD, Berman JJ, Corless C, et al. Diagnosis of gastrointestinal stromal tumors: a consensus approach. Hum Pathol 2002;33:459-65.

10. Levy AD, Remotti HE, Thompson WM, Miettinen MM. Gastrointestinal stromaltumors: Radiologic features with pathologic correlation. Radiographics 2003;23:283-304.

11. Arantes V, Logroño R, Faruqi S, Ahmed I, Waxman I, Bhutani MS. Endoscopic sonographically guided fine-needle aspiration yield in submucosaltumors of the gastrointestinal tract. J Ultrasound Med 2004;23:1141-50.

12. Maleki Z, Erozan Y, Geddes S, Kay Li Q. Endorectal Ultrasound- Guided Fine-Needle Aspiration: A Useful Diagnostic Tool for Perirectal and Intraluminal Lesions. Acta Cytol 2013;57:9-18.

13. Iglesias-Garcia J, Poley JW, Larghi A et al. Feasibility and yield of a new EUS histology needle: results from a multicente, pooled, cohorte study. Gastrointest Endosc 2011;73:1189-96.

14. Hellan M, Maker V K. Transvaginal excision of a large rectal stromal tumor: an alternative. Am J Surg 2006;191:121-23.