A rare giant gastrointestinal stromal tumor (GIST) of the stomach traversing the upper abdomen: a case report and literature review

World Journal of Surgical Oncology (Impact Factor: 1.41). 04/2012; 10(1):66. DOI: 10.1186/1477-7819-10-66
Source: PubMed


This article presents a 66-year-old woman with a huge GIST of stomach that traverses the upper abdomen. With only the predominant abdominal sign featuring a palpable huge mass, but none special physical findings and routine blood as well as biochemical markers, it could hardly judge where the mass drive from upon the images. Furthermore, many important blood vessels had a complex relationship with the mass according to radiological findings. An exploratory laparotomy revealed a huge tumor that protrude from prior wall of stomach fundus, lesser curvature of stomach side, measuring approximately 21 x 34 x 11 cm in diameter and weighing 5.5Kg. A completely resection was decided on the tumor and the department of pathology immunohistochemically characterized it (CD117, CD34, Dog-1, etc) as a GIST of stomach. Preoperatively diagnosis of GISTs is still sometimes puzzling. Hoping the presentation of this rare case and the literature review could benefit others in similar problems.

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Article: A rare giant gastrointestinal stromal tumor (GIST) of the stomach traversing the upper abdomen: a case report and literature review

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    • "As the most common mesenchymal neoplasm of the GI tract, GIST manifests itself inconsistently in patients and requires immunohistochemical means to establish a definitive diagnosis. Studies indicate that approximately 95% of the cases are KIT positive which confers the tumor with proliferative potential as well as the ability to evade apoptotic pathways [6]. "
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    ABSTRACT: Background Gastrointestinal stromal tumor (GIST) is a rare tumor comprising 0.1-0.3% of all gastrointestinal (GI) malignancies. Stomach followed by small intestine is the most common sites of involvement, implicated in 95% of the cases. We present a case of GIST complicating a colonic interposition. To the best of the author's knowledge, this is the first reported case of GIST complicating a colonic interposition. Case presentation A 47 year old African American male presented to the emergency department with intermittent, severe chest pain. Past medical history was significant for alkali (NaOH) ingestion during 1980 for which esophageal resection and a colonic pull-through was performed. A CXR revealed a widened mediastinum and CT scan chest revealed showed a large (11.4 × 8.3 × 12.1 cm) vascular mediastinal mass. At endoscopy, a large, ulcerated, cratered and friable mass was found at 29cm extending to 36cm at which point the lower anastomosis of the colonic pull through was present. Multiple endoscopic biopsies were obtained which showed that the tumor was immunoreactive with CD117, CD34 and DOG1 while markers of carcinoma, melanoma and lymphoma were negative. In light of the pathology report, the immunohistochemistry and the CT scans, the tumor was classified as a stage 4 GIST of colonic interposition. Conclusions GIST can complicate unusual locations such as colonic interposition and should be kept in the differential diagnosis of such unusual presentations.
    BMC Research Notes 09/2014; 7(1):604. DOI:10.1186/1756-0500-7-604
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    • "In many cases, GISTs present with abdominal pain, GI bleeding or palpable mass. In other cases, they may be revealed because of a complication: bowel obstruction, spontaneous rupture into the peritoneal cavity leading to peritonitis, or tumor rupture into the stomach [8-10]. We report an unusual case of a giant GIST that caused a proximal bowel obstruction. "
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    ABSTRACT: Gastrointestinal stromal tumors (GISTs) represent 85% of all mesenchymal neoplasms that affect the gastrointestinal (GI) tract. These GISTs range in size from small lesions to large masses. Often they are clinically silent until they reach a significant size, so their discovery is usually incidental. A 67-year-old man was admitted at our general surgery department with a persistent abdominal pain in the left hypochondrium, associated with nausea and vomiting. Clinical examination revealed a palpable mass in the epigastrium and in the left hypochondrium, which was approximately 40 cm long. Ultrasonography and computed tomography of the abdomen showed a large mass of 40 x 25 cm, which extended from the posterior wall of the stomach to the spleen, involving the body and the tail of the pancreas. The patient underwent en-block resection of the mass, sleeve resection of the stomach, and distal pancreatectomy-splenectomy. The histopathology of the resected specimen was consistent with a gastrointestinal stromal tumor of the stomach (positive for CD 117) with a high risk of malignancy (mitotic count >5/50 high-power fieldand Ki67/Mib1 >10%). The postoperative course was uneventful and treatment with imatinib mesylate began immediately. The patient appears to be disease free after four years. Giant GISTs of the stomach are rare. Surgical resection with curative intent is feasible. The combination of surgical resection and imatinib can provide long-termdisease-free survival. An R0 resection is the best achievable treatment, therefore the patient should be evaluated over time for potential resectability.
    World Journal of Surgical Oncology 08/2013; 11(1):172. DOI:10.1186/1477-7819-11-172 · 1.41 Impact Factor
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    ABSTRACT: Glomus tumours of the stomach are rare mesenchymal neoplasms. Since patients have no specific clinical and radiological findings, the differential diagnosis with other gastric submucosal tumours can be difficult. Histologic and immunohistochemical findings help distinguishing different tumours. Although usually benign, a malignant behaviour cannot be excluded. The treatment of choice is wide surgical resection with negative margins, and the laparoscopic approach is a safe and effective option. We report the case of a patient presenting with a symptomatic lesion originating in the anterior gastric wall who underwent successful laparoscopic wedge resection.
    Acta Endoscopica 12/2014; 44(6):378-381. DOI:10.1007/s10190-014-0398-5 · 0.16 Impact Factor
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