제1형 신경섬유종증에서 발생한 위 악성 말초신경초종양

• Published in: The Korean journal of gastroenterology Vol. 79; no. 6; pp. 265 - 269
• Main Authors: 황현승, Hyun Seung Hwang, 정윤진, Yun Jin Jeong, 남경한, Kyung Han Nam, 오성진, Sung Jin Oh, 박용은, Yong Eun Park
• Format: Journal Article
• Language: Korean
• Published: 대한소화기학회 30-06-2022
• Subjects: Gastric subepithelial lesion; Malignant peripheral nerve sheath tumor; Neurofibromatosis 1
• ISSN: 1598-9992

Gastric malignant peripheral nerve sheath tumors (MPNSTs) are extremely rare spindle cell sarcomas that arise within the peripheral nerves of the gastrointestinal tract. MPNST can present as a mass that may or may not be accompanied by obstruction or bleeding. Type 1 neurofibromatosis (NF) is an autosomal dominant genetic disorder with an incidence of 1 in 2,500-3,000. Plexiform neurofibromas in Type 1 NF can undergo a malignant transformation to MPNSTs. Approximately half of the incidence of MPNST is associated with the NF-1 gene. MPNST behaves aggressively, and radical excisional surgery is important for treatment. Recurrence and metastasis are significant, even after a radical excision. Despite multidisciplinary treatment, the five-year survival rate is only 30-50%. This paper reports the case of a 47-year-old man with Type 1 NF who presented with hemorrhage of a gastric subepithelial lesion. He underwent surgery under the suspicion of a gastrointestinal stromal tumor, but it was diagnosed as MPNST after confirming the histopathological appearance and immunohistochemical profiles. In addition, the large mass invaded the spleen and diaphragm. Radical surgery was performed, and additional chemotherapy was administered. This paper reports the experience of a patient with NF 1 with advanced MPNST discovered due to a subepithelial lesion. (Korean J Gastroenterol 2022;79:265-269)