Synchronous gastric and colonic cancer – A case report

Bratislav Trifunović; Branimir Nešković; Mihailo Bezmarević; Jovan Kršić; Milić Veljović; Dejan Zeljković

doi:10.2298/6361

Bratislav Trifunović Clinic of General Surgery Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Branimir Nešković Clinic of General Surgery Military Medical Academy, Belgrade, Serbia
Mihailo Bezmarević Clinic of General Surgery Military Medical Academy, Belgrade, Serbia
Jovan Kršić Clinic of General Surgery Military Medical Academy, Belgrade, Serbia
Milić Veljović Clinic of Anesthesiology and Critical Care, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Dejan Zeljković Clinic of General Surgery Military Medical Academy, Belgrade, Serbia

DOI: https://doi.org/10.2298/6361

Ključne reči: neoplasms, multiple primary||, ||neoplazme, multiple, primarne, stomach neoplasms||, ||želudac, neoplazme, colonic neoplasms||, ||kolon, diagnostic techniques and procedures||, ||dijagnostičke tehnike i procedure, histology||, ||histologija, digestive system surgical procedures||, ||hirurgija digestivnog sistema, procedure,

Sažetak

Uvod. Istovremeni karcinom želuca i debelog creva javlja se kod 4% bolesnika, obično kao uzgredan nalaz. Prikazali smo primer invazivnog, sinhronog karcinoma želuca i sigmoidnog kolona. Prikaz bolesnika. Bolesnik, star 63 godine, primljen je u našu ustanovu zbog bola u epigastrijumu, povraćanja, naglog gubitka telesne mase i povremene opstipacije. Ezofagogastroduodenoskopijom (EGDS) verifikovan je ulceroinfiltrativni tumor fundusa želuca, a kolonoskopski stenozirajući tumor sigmoidnog kolona. Multislajsnom kompjuterizovanom tomografijom (MSCT) grudnog koša i abdomena utvrđeno je postojanje promene u desnom plućnom krilu. Videoskopskom torakoskopijom (VATS) i biopsijom promene desnog pluća isključena je diseminacija. Učinjena je totalna gastrektomija sa omentektomijom, splenektomijom, D2 limfadenektomijom i tipična leva hemikolektomija. Patohistološkim pregledom verifkovan je invazivni, difuzni adenokarcinom želuca i invazivni, tubularni adenokarcinom kolona. Primenjena je sistemska postoperativna hemoterapija. Bolesnik je živ, bez znakova recidiva, 2 godine posle operacije. Zaključak. Postojanje simptomatologije koja ne odgovara primarnom malignitetu zahteva dodatnu dijagnostiku. Kombinovana resekcija je adekvatna hirurška procedura

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