中国肿瘤外科杂志2026，Vol.18Issue(2)：178-185,8.DOI:10.3969/j.issn.1674-4136.2026.02.012
多学科协作诊疗1例胃肝样腺癌伴肝转移合并胰腺神经内分泌肿瘤
Multidisciplinary collaborative management of a case of hepatoid adenocarcinoma of the stomach with liver metastasis and concomitant pancreatic neuroendocrine tumor
摘要
Abstract
Objective To summarize the application of multidisciplinary team(MDT)management in a patient with hepatoid adenocarcinoma of the stomach(HAS)complicated by multi-organ involvement,and to evaluate the value of MDT in the diagnosis and comprehensive treatment of this rare gastric cancer subtype.Methods Clinical data of a patient diagnosed with HAS with liver metastasis and a concurrent pancreatic neuroendocrine tumor at Jiangsu Cancer Hospital were retrospectively reviewed.Endoscopy,CT/MRI,PET-CT,liver biopsy,and immunohistochemistry were integrated,and three MDT discussions were documented.Diagnostic challenges,surgical strategy for multi-organ resection,and perioperative management were analyzed.Results The patient presented with a cardia lesion and mildly elevated AFP,with imaging lacking typical HAS features.MDT-guided evaluation confirmed HAS with liver metastasis and a pancreatic neuroendocrine tumor.The patient underwent radical proximal gastrectomy with D2 lymphadenectomy,hepatic tumor resection,and spleen-preserving distal pancreatectomy,followed by SOX chemotherapy.Recovery was favorable,with no recurrence to date.Conclusions MDT improves diagnostic accuracy,enhances the safety and feasibility of multi-organ resection,and supports individualized perioperative and postoperative management in complex HAS cases.关键词
MDT讨论/胃肝样腺癌/胰腺神经内分泌肿瘤/肝转移/根治性手术Key words
MDT-based discussion/Hepatoid adenocarcinoma of the stomach/Pancreatic neuroendocrine tumor/Liver metastasis/Radical surgery引用本文复制引用
王哲,卢有胜,夏雷,白晨光,孙岩,刘辉,彭锐,李刚..多学科协作诊疗1例胃肝样腺癌伴肝转移合并胰腺神经内分泌肿瘤[J].中国肿瘤外科杂志,2026,18(2):178-185,8.基金项目
江苏省肿瘤医院"移山计划"重点项目(YSZD202404) （YSZD202404）
江苏肿瘤医院群峰计划项目(GFXK202503) （GFXK202503）
江苏省肿瘤医院科技发展基金项目(XHMS202401、RCQY202501) （XHMS202401、RCQY202501）
江苏省"333工程"高层次人才培养计划(2024-3-2249) （2024-3-2249）
