Rare monomorphic epithelial intestinal T-cell lymphoma of the stomach with a giant gastric perforation rescued by liver-covering sutures followed by a total gastrectomy and lateral hepatectomy: a case report

Abstract Background Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), a type of peripheral T-cell lymphoma, rarely involves the stomach as the primary organ. Advanced MEITL, for which there is currently no established treatment, causes gastrointestinal perforations and is characterized...

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Main Authors: Keiji Muramoto, Sachiko Kaida, Toru Miyake, Rie Nishimura, Katsuyuki Kito, Masanori Shiohara, Ryoji Kushima, Tomoharu Shimizu, Masaji Tani
Format: Article
Language:English
Published: Japan Surgical Society 2022-02-01
Series:Surgical Case Reports
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Online Access:https://doi.org/10.1186/s40792-022-01381-1
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author Keiji Muramoto
Sachiko Kaida
Toru Miyake
Rie Nishimura
Katsuyuki Kito
Masanori Shiohara
Ryoji Kushima
Tomoharu Shimizu
Masaji Tani
author_facet Keiji Muramoto
Sachiko Kaida
Toru Miyake
Rie Nishimura
Katsuyuki Kito
Masanori Shiohara
Ryoji Kushima
Tomoharu Shimizu
Masaji Tani
author_sort Keiji Muramoto
collection DOAJ
description Abstract Background Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), a type of peripheral T-cell lymphoma, rarely involves the stomach as the primary organ. Advanced MEITL, for which there is currently no established treatment, causes gastrointestinal perforations and is characterized by a poor response to chemotherapy. Case presentation A 69-year-old man had undergone chemotherapy for MEITL of the whole stomach. He subsequently developed acute abdominal pain, and computed tomography revealed a giant perforation in the anterior gastric wall adjacent to the lateral segment of the liver. The perforation was rescued through closure with liver-covering sutures. Thereafter, a total gastrectomy and a left hepatectomy were performed and he recovered enough to tolerate oral intake. However, despite ongoing chemotherapy, the patient died 83 days after the gastric perforation (10 months after being diagnosed with the lymphoma) owing to rapid progression of the MEITL. Conclusion In the rare case of a giant gastric perforation after chemotherapy for gastric MEITL, rescue is possible through liver-covering sutures followed by a total gastrectomy and lateral hepatectomy.
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spelling doaj-art-e6e28677cf7f4d529608f2ba331b99302025-08-20T03:57:59ZengJapan Surgical SocietySurgical Case Reports2198-77932022-02-01811710.1186/s40792-022-01381-1Rare monomorphic epithelial intestinal T-cell lymphoma of the stomach with a giant gastric perforation rescued by liver-covering sutures followed by a total gastrectomy and lateral hepatectomy: a case reportKeiji Muramoto0Sachiko Kaida1Toru Miyake2Rie Nishimura3Katsuyuki Kito4Masanori Shiohara5Ryoji Kushima6Tomoharu Shimizu7Masaji Tani8Department of Surgery, Shiga University of Medical ScienceDepartment of Surgery, Shiga University of Medical ScienceDepartment of Surgery, Shiga University of Medical ScienceDepartment of Gastroenterology and Hematology, Shiga University of Medical ScienceDepartment of Gastroenterology and Hematology, Shiga University of Medical ScienceDepartment of Clinical Laboratory Medicine and Diagnostic Pathology, Shiga University of Medical ScienceDepartment of Clinical Laboratory Medicine and Diagnostic Pathology, Shiga University of Medical ScienceMedical Safety Section, Shiga University of Medical Science HospitalDepartment of Surgery, Shiga University of Medical ScienceAbstract Background Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL), a type of peripheral T-cell lymphoma, rarely involves the stomach as the primary organ. Advanced MEITL, for which there is currently no established treatment, causes gastrointestinal perforations and is characterized by a poor response to chemotherapy. Case presentation A 69-year-old man had undergone chemotherapy for MEITL of the whole stomach. He subsequently developed acute abdominal pain, and computed tomography revealed a giant perforation in the anterior gastric wall adjacent to the lateral segment of the liver. The perforation was rescued through closure with liver-covering sutures. Thereafter, a total gastrectomy and a left hepatectomy were performed and he recovered enough to tolerate oral intake. However, despite ongoing chemotherapy, the patient died 83 days after the gastric perforation (10 months after being diagnosed with the lymphoma) owing to rapid progression of the MEITL. Conclusion In the rare case of a giant gastric perforation after chemotherapy for gastric MEITL, rescue is possible through liver-covering sutures followed by a total gastrectomy and lateral hepatectomy.https://doi.org/10.1186/s40792-022-01381-1Monomorphic epitheliotropic intestinal T-cell lymphomaGastric lymphomaPerforationHepatectomy
spellingShingle Keiji Muramoto
Sachiko Kaida
Toru Miyake
Rie Nishimura
Katsuyuki Kito
Masanori Shiohara
Ryoji Kushima
Tomoharu Shimizu
Masaji Tani
Rare monomorphic epithelial intestinal T-cell lymphoma of the stomach with a giant gastric perforation rescued by liver-covering sutures followed by a total gastrectomy and lateral hepatectomy: a case report
Surgical Case Reports
Monomorphic epitheliotropic intestinal T-cell lymphoma
Gastric lymphoma
Perforation
Hepatectomy
title Rare monomorphic epithelial intestinal T-cell lymphoma of the stomach with a giant gastric perforation rescued by liver-covering sutures followed by a total gastrectomy and lateral hepatectomy: a case report
title_full Rare monomorphic epithelial intestinal T-cell lymphoma of the stomach with a giant gastric perforation rescued by liver-covering sutures followed by a total gastrectomy and lateral hepatectomy: a case report
title_fullStr Rare monomorphic epithelial intestinal T-cell lymphoma of the stomach with a giant gastric perforation rescued by liver-covering sutures followed by a total gastrectomy and lateral hepatectomy: a case report
title_full_unstemmed Rare monomorphic epithelial intestinal T-cell lymphoma of the stomach with a giant gastric perforation rescued by liver-covering sutures followed by a total gastrectomy and lateral hepatectomy: a case report
title_short Rare monomorphic epithelial intestinal T-cell lymphoma of the stomach with a giant gastric perforation rescued by liver-covering sutures followed by a total gastrectomy and lateral hepatectomy: a case report
title_sort rare monomorphic epithelial intestinal t cell lymphoma of the stomach with a giant gastric perforation rescued by liver covering sutures followed by a total gastrectomy and lateral hepatectomy a case report
topic Monomorphic epitheliotropic intestinal T-cell lymphoma
Gastric lymphoma
Perforation
Hepatectomy
url https://doi.org/10.1186/s40792-022-01381-1
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