青少年胃滑膜肉瘤1例病例報道及文獻回顧_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

周浪 ^1,2 , 吉克-木基列沙 ^1,2 , 張維漢 ^1,2 ,  陳小龍 ^1,2 ,  楊昆 ^1,2 , 胡建昆 ^1,2

1. ;
2. ;

Corresponding?author：

陳小龍, Email: 626290977@qq.com; 楊昆, Email: yangkun068@163.com

Keywords：

胃滑膜肉瘤; 青少年; 腹腔鏡手術; 輔助化療

DOI：

10.7507/1007-9424.202509141

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的探討胃滑膜肉瘤的臨床特征。方法回顧性收集四川大學華西醫院胃癌中心于2025年1月收治的1例青少年胃滑膜肉瘤患者的臨床資料，并對已發表的胃滑膜肉瘤相關報道進行文獻回顧。結果該例青少年胃滑膜肉瘤患者因上腹疼痛伴黑便入院，胃鏡檢查示胃體下部1個直徑約30 mm的隆起性包塊，活檢未能明確性質。經全腹腔鏡切除后，免疫組織化學檢查提示EMA、TLE1陽性，下一代基因測序檢測到 SS18-SSX2 融合基因，最終被確診為原發性胃滑膜肉瘤。患者術后接受了4個周期的輔助化療，獲訪8個月，末次隨訪時身體狀況良好。進一步系統檢索中英文數據庫，篩選出61例胃滑膜肉瘤患者，結合本例共 62 例。匯總顯示，患者年齡13～70歲（平均45歲），腫瘤最大徑6～160 mm（平均51.5 mm），胃體為好發部位（30例），組織學類型單相型多見（38例），術式以胃部分切除為主（22例），少部分患者（9例）術后接受阿霉素聯合異環磷酰胺化療。結論原發性胃滑膜肉瘤臨床罕見，其預后隨腫瘤直徑和分化程度而異，鑒別診斷中需考慮胃腸道間質瘤與肉瘤樣癌。多學科綜合治療或許可以為該類患者帶來生存獲益。

1.	Gazendam AM, Popovic S, Munir S, et al. Synovial sarcoma: a clinical review. Curr Oncol, 2021, 28(3): 1909-1920.
2.	Mastrangelo G, Coindre JM, Ducimetière F, et al. Incidence of soft tissue sarcoma and beyond: a population-based prospective study in 3 European regions. Cancer, 2012, 118(21): 5339-5348.
3.	Herzog CE. Overview of sarcomas in the adolescent and young adult population. J Pediatr Hematol Oncol, 2005, 27(4): 215-218.
4.	Bakri A, Shinagare AB, Krajewski KM, et al. Synovial sarcoma: imaging features of common and uncommon primary sites, metastatic patterns, and treatment response. AJR Am J Roentgenol, 2012, 199(2): W208-W215.
5.	Banito A, Li X, Laporte AN, et al. The SS18-SSX oncoprotein hijacks KDM2B-PRC1. 1 to drive synovial sarcoma. Cancer Cell, 2018, 34(2): 346-348.
6.	Yoshiyasu K, Kono H, Hojo Y, et al. A minute primary gastric synovial sarcoma with ulcer: a case report. Diagn Pathol, 2021, 16(1): 115.
7.	Manohar A, Gopal C, Premalata CS, et al. Primary gastric synovial sarcoma in a child: a case report and review of the literature. J Pediatr Hematol Oncol, 2021, 43(1): e119-e122.
8.	Yamazawa S, Ushiku T. Carcinosarcoma of the stomach: four cases that expand the morphologic spectrum of gastric cancer with a primitive phenotype. Virchows Arch, 2022, 480(5): 1051-1062.
9.	Hayashi H, Makiyama A, Okumura N, et al. Gastric carcinosarcoma with FGFR2 amplification under long-term control with pazopanib: a case report and literature review. BMC Gastroenterol, 2022, 22(1): 360.
10.	Romeo S, Rossi S, Acosta Marín M, et al. Primary synovial sarcoma (SS) of the digestive system: a molecular and clinicopathological study of fifteen cases. Clin Sarcoma Res, 2015, 5(1): 7.
11.	Ogino S, Konishi H, Ichikawa D, et al. Detection of fusion gene in cell-free DNA of a gastric synovial sarcoma. World J Gastroenterol, 2018, 24(8): 949-956.
12.	陸亦非, 董瑞. 兒童軟組織肉瘤診斷和治療研究進展. 中華小兒外科雜志, 2023, 44(4): 361-366.
13.	Shibata R, Morishita M, Koreeda N, et al. Primary gastric synovial sarcoma resected by laparoscopic endoscopic cooperative surgery of the stomach: a case report. Surg Case Rep, 2021, 7(1): 225.
14.	Sato Y, Morita S, Yoshida A, et al. Small gastric synovial sarcoma diagnosed and treatment by laparoscopic-endoscopic cooperative surgery: a case report. Clin J Gastroenterol, 2024, 17(1): 18-22.
15.	Rivelli M, Fernandes E, Conti C, et al. Laparoscopic intragastric resection of gastric synovial sarcoma: report of the first ever case with video demonstration. World J Surg Oncol, 2021, 19(1): 65.
16.	Billings SD, Meisner LF, Cummings OW, et al. Synovial sarcoma of the upper digestive tract: a report of two cases with demonstration of the X;18 translocation by fluorescence in situ hybridization. Mod Pathol, 2000, 13(1): 68-76.
17.	Marchand Crety C, Bellefqih S, Amroun K, et al. Primary gastric synovial sarcoma: a case report and literature review. Int J Surg Case Rep, 2021, 78: 270-273.
18.	Bergh P, Meis-Kindblom JM, Gherlinzoni F, et al. Synovial sarcoma: identification of low and high risk groups. Cancer, 1999, 85(12): 2596-2607.
19.	Deshmukh R, Mankin HJ, Singer S. Synovial sarcoma: the importance of size and location for survival. Clin Orthop Relat Res, 2004, 419: 155-161.
20.	Scheer M, Vokuhl C, Bauer S, et al. The effect of adjuvant therapies on long-term outcome for primary resected synovial sarcoma in a series of mainly children and adolescents. J Cancer Res Clin Oncol, 2021, 147(12): 3735-3747.
21.	Trassard M, Le Doussal V, Hacène K, et al. Prognostic factors in localized primary synovial sarcoma: a multicenter study of 128 adult patients. J Clin Oncol, 2001, 19(2): 525-534.
22.	Okcu MF, Munsell M, Treuner J, et al. Synovial sarcoma of childhood and adolescence: a multicenter, multivariate analysis of outcome. J Clin Oncol, 2003, 21(8): 1602-1611.
23.	Frustaci S, Gherlinzoni F, De Paoli A, et al. Adjuvant chemotherapy for adult soft tissue sarcomas of the extremities and girdles: results of the Italian randomized cooperative trial. J Clin Oncol, 2001, 19(5): 1238-1247.
24.	Ferrari A, Gronchi A, Casanova M, et al. Synovial sarcoma: a retrospective analysis of 271 patients of all ages treated at a single institution. Cancer, 2004, 101(3): 627-634.
25.	趙吉龍, 劉巍峰. 2023年美國臨床腫瘤學年會軟組織肉瘤治療進展. 中華腫瘤雜志, 2024, 46(1): 48-56.

1. Gazendam AM, Popovic S, Munir S, et al. Synovial sarcoma: a clinical review. Curr Oncol, 2021, 28(3): 1909-1920.
2. Mastrangelo G, Coindre JM, Ducimetière F, et al. Incidence of soft tissue sarcoma and beyond: a population-based prospective study in 3 European regions. Cancer, 2012, 118(21): 5339-5348.
3. Herzog CE. Overview of sarcomas in the adolescent and young adult population. J Pediatr Hematol Oncol, 2005, 27(4): 215-218.
4. Bakri A, Shinagare AB, Krajewski KM, et al. Synovial sarcoma: imaging features of common and uncommon primary sites, metastatic patterns, and treatment response. AJR Am J Roentgenol, 2012, 199(2): W208-W215.
5. Banito A, Li X, Laporte AN, et al. The SS18-SSX oncoprotein hijacks KDM2B-PRC1. 1 to drive synovial sarcoma. Cancer Cell, 2018, 34(2): 346-348.
6. Yoshiyasu K, Kono H, Hojo Y, et al. A minute primary gastric synovial sarcoma with ulcer: a case report. Diagn Pathol, 2021, 16(1): 115.
7. Manohar A, Gopal C, Premalata CS, et al. Primary gastric synovial sarcoma in a child: a case report and review of the literature. J Pediatr Hematol Oncol, 2021, 43(1): e119-e122.
8. Yamazawa S, Ushiku T. Carcinosarcoma of the stomach: four cases that expand the morphologic spectrum of gastric cancer with a primitive phenotype. Virchows Arch, 2022, 480(5): 1051-1062.
9. Hayashi H, Makiyama A, Okumura N, et al. Gastric carcinosarcoma with FGFR2 amplification under long-term control with pazopanib: a case report and literature review. BMC Gastroenterol, 2022, 22(1): 360.
10. Romeo S, Rossi S, Acosta Marín M, et al. Primary synovial sarcoma (SS) of the digestive system: a molecular and clinicopathological study of fifteen cases. Clin Sarcoma Res, 2015, 5(1): 7.
11. Ogino S, Konishi H, Ichikawa D, et al. Detection of fusion gene in cell-free DNA of a gastric synovial sarcoma. World J Gastroenterol, 2018, 24(8): 949-956.
12. 陸亦非, 董瑞. 兒童軟組織肉瘤診斷和治療研究進展. 中華小兒外科雜志, 2023, 44(4): 361-366.
13. Shibata R, Morishita M, Koreeda N, et al. Primary gastric synovial sarcoma resected by laparoscopic endoscopic cooperative surgery of the stomach: a case report. Surg Case Rep, 2021, 7(1): 225.
14. Sato Y, Morita S, Yoshida A, et al. Small gastric synovial sarcoma diagnosed and treatment by laparoscopic-endoscopic cooperative surgery: a case report. Clin J Gastroenterol, 2024, 17(1): 18-22.
15. Rivelli M, Fernandes E, Conti C, et al. Laparoscopic intragastric resection of gastric synovial sarcoma: report of the first ever case with video demonstration. World J Surg Oncol, 2021, 19(1): 65.
16. Billings SD, Meisner LF, Cummings OW, et al. Synovial sarcoma of the upper digestive tract: a report of two cases with demonstration of the X;18 translocation by fluorescence in situ hybridization. Mod Pathol, 2000, 13(1): 68-76.
17. Marchand Crety C, Bellefqih S, Amroun K, et al. Primary gastric synovial sarcoma: a case report and literature review. Int J Surg Case Rep, 2021, 78: 270-273.
18. Bergh P, Meis-Kindblom JM, Gherlinzoni F, et al. Synovial sarcoma: identification of low and high risk groups. Cancer, 1999, 85(12): 2596-2607.
19. Deshmukh R, Mankin HJ, Singer S. Synovial sarcoma: the importance of size and location for survival. Clin Orthop Relat Res, 2004, 419: 155-161.
20. Scheer M, Vokuhl C, Bauer S, et al. The effect of adjuvant therapies on long-term outcome for primary resected synovial sarcoma in a series of mainly children and adolescents. J Cancer Res Clin Oncol, 2021, 147(12): 3735-3747.
21. Trassard M, Le Doussal V, Hacène K, et al. Prognostic factors in localized primary synovial sarcoma: a multicenter study of 128 adult patients. J Clin Oncol, 2001, 19(2): 525-534.
22. Okcu MF, Munsell M, Treuner J, et al. Synovial sarcoma of childhood and adolescence: a multicenter, multivariate analysis of outcome. J Clin Oncol, 2003, 21(8): 1602-1611.
23. Frustaci S, Gherlinzoni F, De Paoli A, et al. Adjuvant chemotherapy for adult soft tissue sarcomas of the extremities and girdles: results of the Italian randomized cooperative trial. J Clin Oncol, 2001, 19(5): 1238-1247.
24. Ferrari A, Gronchi A, Casanova M, et al. Synovial sarcoma: a retrospective analysis of 271 patients of all ages treated at a single institution. Cancer, 2004, 101(3): 627-634.
25. 趙吉龍, 劉巍峰. 2023年美國臨床腫瘤學年會軟組織肉瘤治療進展. 中華腫瘤雜志, 2024, 46(1): 48-56.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Latest Articles青少年胃滑膜肉瘤1例病例報道及文獻回顧

Abstract Full text Figures/Tables Video References Cited by

Format

Content