Advisory conclusion, biopsy and recommendations
Patient’s name: Zherlitsyna Anastasia Stanislavivna Date of birth: April 25, 1976 ID 110889 |
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ADVISORY CONCLUSION
Diagnosis: Leiomyosarcoma of the uterine body, T2NxM1, secondary damage to the liver, peritoneum. Condition after 4 cycles of chemotherapy according to the Gemcitabine + Docetaxel + Avastin protocol with progression of the disease in the liver (according to CT, MRI from 10/2022). C-KIT, MET (ONCOMINE) mutation was detected. The condition after treatment with Pazopanib (05-12/01/2023) with the development of the posterior reverse encephalopathy syndrome and positive dynamics according to the CT scan.
01/2023 - repeated liver biopsy. Pathohistological conclusion - metastasis of uterine leiomyosarcoma. Condition after 3 cycles of chemotherapy according to the Trabectedin protocol with negative X-ray dynamics (PET/CT from 11/04/2023). Suspicion of the presence of synchronous neoplasia of the stomach (GIST?). Condition after EUS-FNA gastric biopsy.
Recommended:
Taking into account the variability of the activity of the lesions according to PET/CT data, if there is a suspicion of the presence of synchronous neoplasia, it is advisable to carry out a repeated liver biopsy + blood sampling for FoundationONE CDx + FoundationONE Liquid studies.
Further tactics will be determined after receiving the results of the additional examination
This opinion is provided based solely on the material provided by the patient.
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Department of diagnostic and interventional endoscopy
Endo Ultrasonography of the stomach wall, fine-needle aspiration biopsy
(EUS FNA)
Patient: Zherlitsyna Anastasia Stanislavivna
ID 110889
Date of birth: April 25, 1976
Date of study: April 21, 2023
The reason for the examination: the need for a biopsy
Patient: ambulatory.
Video system: Olympus Evis Exera ІІІ,
Endo Ultrasound system: Olympus EU-C60
Video endoscope: Olympus UCT-160-OL5
Type of disinfection: automatic reprocessor of Olympus OER-AW endoscopes
ASA score: 2
Type of anesthesia: general. Sedation was performed with the drug propofol in combination with local anesthesia with lidocaine solution.
Monitoring: ECG, A/T, Ps, SpO2
Anesthesiologist: Ivashchenko K.P.
Endoscopic nurse: Lisovetska S.V.
Informed consent for anesthesia provision and endoscopic intervention was obtained after explaining to the patient all the risks, possible consequences and results of the specified intervention.
Protocol:
Next to the antral part of the stomach, from the side of the back wall and the lesser curvature, an irregular shape, close to bean-shaped, measuring 55x32, is hypoechoic with anechoic zones up to 10 mm in size. The border between the formation and the muscle layer of the stomach wall is not defined (the formation grows in or originates from the muscle layer of the stomach wall).
A fine-needle aspiration biopsy was performed - three punctures.
Material for histological and cytological research was obtained.
Conclusion: Paragastric formation extending to the muscular layer of the stomach wall (or originating from it)
Head of the Department
of Diagnostic and Interventional Endoscopy
Vadim Stepanovych Korpyak
If you have suggestions and comments regarding the work of our hospital, please inform us about it by calling the Lisod Hospital Hotline - 0 800 50 51 58 (toll-free from any phone number within Ukraine).