Article

Ruptured gastrointestinal stromal tumors: radiologic findings in six cases.

Department of Radiology, Hospital Morales Meseguer, Avenida Marqués de los Vélez, S/N, CP, 30008 Murcia, Spain.
Abdominal Imaging (impact factor: 1.73). 30(5):535-42. DOI:10.1007/s00261-005-0308-6 pp.535-42
Source: PubMed

ABSTRACT Gastrointestinal stromal tumors (GISTs) are characterized by the expression of c-KIT (antigen CD 117) and are the most common mesenchymal tumors of the digestive tract. An important complication, although infrequently described in the literature, is the rupture of these tumors with accompanying hemoperitoneum.
We performed a retrospective evaluation of the clinical history and radiologic records of 23 patients with a diagnosis of GIST and anatomopathologic and immunohistochemical confirmation at our hospital between 1999 and 2004.
In five cases there was rupture of the primary tumor (four gastric and one jejunal). In all five cases ultrasonographic and computed tomographic examinations showed a heterogenic tumor of laminated or whirled appearance, associated with echogenic or dense ascites. No relation was found between histologic criteria of malignancy and the rupture. Four patients underwent surgical intervention, three of them urgently. Two of five patients died. There was a sixth case with rupture of a hepatic metastasis, with accompanying hemoperitoneum and subcapsular hematoma. This patient died at 3 months, after recurrence of bleeding.
The finding of a heterogeneous tumor of laminated or whirled appearance associated with ascites with characteristics compatible with hemoperitoneum in an appropriate context must lead to a suspicion of the existence of a ruptured GIST.

0 0
 · 
0 Bookmarks
 · 
20 Views
  • Source
    Article: An unusual presentation of a Gastrointestinal stromal tumour (GIST).
    Solomon Kp John, Sanjoy Basu, Richard J Lawrance, Nick Davies
    [show abstract] [hide abstract]
    ABSTRACT: Gastrointestinal stromal tumours (GIST) are rare tumours, now more frequently identified with the new imaging modalities like computerised tomography (CT) and magnetic resonance imaging (MRI). We report a rare presentation of a GIST with an unusual diagnostic workup in a multidisciplinary setting leading to a definitive diagnosis and treatment. A 55-year-old lady was admitted under the general surgeons, with 3-day history of abdominal pain, three-week history of loss of appetite and weight. The patient was sequentially investigated with ultrasonography, computerised tomography and finally selective angiogram in a multidisciplinary setting. The selective angiogram showed a GIST with intratumour bleed, leading to successful surgical excision and being recurrence free at 22 month follow up. Clinical presentation of these tumours can be varied and gastrointestinal bleeding is the commonest mode described in the literature. The clinician needs to be aware of much more rare presentations of the GIST including an intra tumour bleed. A structured multidisciplinary approach would lead to successful diagnosis and treatment.
    World Journal of Surgical Oncology 02/2007; 5:78. · 1.12 Impact Factor
  • Source
    Article: Spontaneous intraperitoneal hemorrhage as the initial presentation of a gastrointestinal stromal tumor: a case report.
    Benjamin B Freeman, Jonathan F Critchlow, Steven Cohen, Jonathan A Edlow
    [show abstract] [hide abstract]
    ABSTRACT: Spontaneous hemoperitoneum is rare. The most common etiologies are gynecologic, splenic, and hepatic. Gastrointestinal stromal tumors (GISTs) are commonly associated with intraluminal bleeding, but rarely with spontaneous hemoperitoneum. We report a case of spontaneous hemoperitoneum caused by a gastric GIST. A 54-year-old male presented with the acute onset of abdominal pain and a drop in hemoglobin. Subsequent evaluation, including a CT, MRI, and EUS, revealed a 1.2-cm mass along the greater curvature of the stomach and associated hemoperitoneum. The patient was taken electively to the operating room for laparoscopic removal of the mass. Pathology confirmed that it was a GIST. GIST is a rare clinical entity that infrequently presents with spontaneous hemoperitoneum. Emergent treatment should be guided towards treating the spontaneous hemoperitoneum.
    International Journal of Emergency Medicine 01/2010; 3(1):53-6.
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.

Keywords

23 patients
 
3 months
 
antigen CD 117
 
characteristics compatible
 
clinical history
 
common mesenchymal tumors
 
computed tomographic examinations
 
dense ascites
 
digestive tract
 
Gastrointestinal stromal tumors
 
GISTs
 
hepatic metastasis
 
heterogeneous tumor
 
heterogenic tumor
 
histologic criteria
 
immunohistochemical confirmation
 
primary tumor
 
radiologic records
 
ruptured GIST
 
subcapsular hematoma
 

M F Cegarra Navarro