Más allá del tumor del estroma gastrointestinal (GISTs)

Más allá del tumor del estroma gastrointestinal (GISTs): Angiomiolipoma gástrico como diagnóstico diferencial en neoplasias mesenquimatosas

Beyond gastrointestinal stromal tumors (GISTS): gastric angiomyolipoma as a differential diagnosis in mesenchymal neoplasms

L. Lavín Montoro*, M. P. Gómez Rodríguez*, J. Martínez Caballero*, E. Rodríguez Cuéllar*

* Servicio de Cirugía General, Aparato Digestivo y Trasplante de
     Órganos Abdominales. Unidad de Cirugía Colorrectal.
     Hospital Universitario 12 de Octubre. Madrid (España).

DOI: https://doi.org/10.14679/4571

Resumen:

El angiomiolipoma gástrico (GAML) es una neoplasia mesenquimatosa extremadamente rara, compuesta por tejido adiposo, células musculares lisas y vasos sanguíneos de paredes engrosadas. La prevalencia del GAML es desconocida debido al escaso número de casos publicados. Puede presentarse en ambos sexos y afecta principalmente a adultos de mediana edad, sin que se haya definido una distribución etaria precisa. En la mayoría de los casos es asintomático y se detecta incidentalmente mediante estudios endoscópicos. Cuando produce síntomas, estos suelen ser inespecíficos, como dolor epigástrico, dispepsia, plenitud postprandial o sangrado digestivo. El diagnóstico definitivo es histológico e inmunohistoquímico, mediante la identificación de sus componentes característicos y marcadores como HMB-45, actina de músculo liso y melan-A. El tratamiento consiste en la resección completa, ya sea quirúrgica o endoscópica. No se han documentado recurrencias ni transformación maligna tras el tratamiento adecuado.
Palabras Clave: Angiomiolipoma gástrico, Neoplasia mesenquimatosa, Anemia, Inmunohistoquímica.

Abstract:

Gastric angiomyolipoma is an extremely rare mesenchymal neoplasm composed of mature adipose tissue, smooth muscle cells, and thick-walled blood vessels.
The prevalence of Gastric angiomyolipoma remains unknown due to the limited number of reported cases. It can occur in both sexes and predominantly affects middle-aged adults, although no definitive age distribution has been established. In most cases, it is asymptomatic and discovered incidentally during endoscopic examinations. When symptoms are present, they are usually non-specific, such as epigastric pain, dyspepsia, postprandial fullness, or gastrointestinal bleeding.
The definitive diagnosis is based on histological and immunohistochemical evaluation, through identification of its characteristic components and expression of markers such as HMB-45, smooth muscle actin, and Melan-A.
Treatment consists of complete resection of the lesion, either surgically or endoscopically. To date, no cases of recurrence or malignant transformation have been documented following appropriate treatment.
Key words: Esophageal Papillomatosis; Squamous Cell Carcinoma; Giant Esophageal Papilloma; endoscopy.

Bibliografía

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