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KMID : 0371320020630050432
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Journal of the Korean Surgical Society
2002 Volume.63 No. 5 p.432 ~ p.436
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Concomitant Gastric and Hepatic Tuberculosis Misconceived as a Malignant Gastrointestinal Stromal Tumor with Hepatic Metastasis
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Kim Say-June
Kim Wook
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Abstract
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Diagnosis of gastric and/or hepatic tuberculosis is often delayed or missed because of its non-specific symptomatology and rare occurrence. We present here a rare case of concomitant gastric and hepatic tuberculosis which was preoperatively
mistaken for
a malignant gastrointestinal stromal tumor (GIST) with hepatic metastasis in a 49- year-old male. The patient, with no past history of pulmonary tuberculosis, was admitted with indigestion and epigastric discomfort for 2 weeks. There were no
abnormal
findings on physical examination and chest radiology. Gastrofiberscopic examination revealed a large, submucosal tumor with central ulceration on the middle third of the stomach and biopsy targeted on the ulceration site showed only chronic
inflammation. Abdominal CT showed an exophytic, ovoid gastric mass having calcified components on the side of lesser curvature with huge, inhomogenous hepatic masses in the left lobe, requiring differentiation from possible hematogenous metastasis
of
gastric lesion, most likely malignant GIST. The patient underwent distal gastrectomy and left lobectomy of the liver. The case was confirmed pathologically as tuberculosis showing confluent epithelioid cell granulomas and multinucleated giant cells
with
caseous necrosis.
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