RARE PRIMARY SMALL BOWEL TUMOR IN THE FORM OF CLASSIC KAPOSI’S SARCOMA: CASE PRESENTATION
| Autor: | Elena Neștian, M. A. Șoitu, B. Mastalier, C. Botezatu |
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| Rok vydání: | 2018 |
| Předmět: | |
| Zdroj: | Journal of Surgical Sciences. 5:153-160 |
| ISSN: | 2457-5364 2360-3038 |
| DOI: | 10.33695/jss.v5i3.229 |
| Popis: | The small bowel represents a rare site for primary neoplasms, with an incidence of less than 2% ofall that are located in the digestive tract. The early diagnosis of these tumors is often difficult due tothe lack of specificity of the clinical presentation, but it can make a difference in matters of 5-yearsurvival rates: 83% (early detection) versus 14% (late detection). We present the case of a malepatient, aged 66, with an apparently benign jejunal ulcer diagnosed endoscopically. Clinicalpresentation: diffuse abdominal pain, fatigability, melena; paraclinical evaluation: anemia,positive occult gastrointestinal bleeding test, superior and inferior endoscopy withouthemorrhagic lesions. The surgical exploration guided by intramucosal dye discovers a 2 cmtumor, 250 cm distal to the angle of Treitz with multiple mesenteric adenopathies. Segmentalresection is performed keeping oncological safety margins with the removal of the lymphaticdrainage elements. The postoperative evolution is favorable and leads to complete healing. Thehistopathological assay finds pathological changes consistent for Kaposi’s sarcoma and confirmsthe presence of HHV-8 in the nuclei of the tumor cells by means of immunohistochemistry. At theexamination of the skin, multiple purple patches were discovered. The particularity of this case isthat the Kaposi’s sarcoma manifests itself in the absence of an immunosuppressive treatment or animmunodeficiency state induced by an HIV infection. Although rare, the small intestine tumorsshould be considered when non-specific abdominal pain is accompanied by positive occult bleedingtest, with scarce endoscopic evidence. Since the Kaposi’s sarcoma is a highly angiogenic tumor, itis prudent to include it in the differential diagnosis when suspecting a source of gastrointestinalbleeding. |
| Databáze: | OpenAIRE |
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