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胃底及胃窦小弯侧平滑肌瘤误诊为肝癌二例报告

CLINICAL MISDIAGNOSIS & MISTHERAPY(2005)

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Abstract
1病例资料 [例1]男,48岁.上腹部疼痛伴腹胀2个月就诊.查体:左上腹可触及一拳头大小的肿块,质硬,活动.查甲胎蛋白(AFP)正常.胃肠钡餐示胃窦小弯侧有一外压性压迹,未见溃疡.彩超提示肝左叶实性占位.CT平扫示:肝左叶区见一肿块,大小5.0 cm×7.6 cm,边缘尚清晰,与肝左叶紧密相连;增强扫描:肿块明显强化,中间可见不规则低密度区,腹腔动脉周围及腹膜后未见大淋巴结.诊断:肝左叶占位(肝癌可能性大).行手术治疗,术中见:胃窦小弯侧肿块,与胃壁有一蒂相连,局部与肝左叶紧密相连,切开肿块呈暗红色.病理诊断为胃平滑肌瘤.
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