A Case Presentation of Gastrointestinal Stromal Tumor of Duodenum

Aamir Ghazanfar,Hassan Mumtaz,Farrukh Zaman,Shahzeb Habib,Afifa Asghar,Shahzaib Ahmad

doi:10.15586/jrenhep.v5i1.112

Abstract

A gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract. It is caused by the mutation in KIT and PDGFRα genes. It constitutes <1% of all gastrointestinal tumors. Duodenal GISTs constitute 4.5% of all GISTs. We report a 61-year-old lady, presented with generalized abdominal pain, vomiting, abdominal distension, and nausea for the last 3 years. Physical exam-ination showed a pallor and on abdominal examination, a large palpable mass was extending from the pelvis to the right upper quadrant of the abdomen. The CT scan showed a large heterogeneously echogenic mass in the abdomen and pelvis with no lymphadenopathy and distant metastasis in this region. Laparotomy showed a large globular mass extending from the pelvis to the right upper quadrant of the abdomen adherent to the wall of a third part of the duodenum. Complete surgical resection of tumor done with an intact capsule. Microscopic examination showed neoplastic spindle cells with tumor necrosis. An immunohistochemical study confirmed GIST.

Highlights

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract [1,2]
GIST of the duodenum is rare than other parts of the small intestine
GISTs and leiomyosarcoma were considered as the same entity but it is revealed that GISTs are CD34 immunoreactive and express tyrosine kinase c-KIT CD117 receptor activity [7]

Summary

Introduction

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract [1,2]. Abdominal examination revealed a large, non-tender palpable mass extending from the pelvis to the right upper quadrant. CT scan of abdomen and pelvis showed a large (18×10×5 cm) heterogeneously enhancing mass in abdomen and pelvis with fairly well-defined margins, displacing abdominal and pelvic viscera. It was inseparable from right adnexal structures and closely abutting the dome of the urinary bladder. Laparotomy with midline incision showed a large globular, irregular, encapsulated mass measuring 20 × 18 ×10.5 cm extending from the pelvis to the right upper quadrant of the abdomen and attached to the wall of a third part of the duodenum. CT scan of abdomen and pelvis with contrast is advised trimonthly for 1 year, 6 monthly for 5 years, and yearly

Discussion

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Conclusions