Abstract
BackgroundGastrointestinal stromal tumor (GIST) can arise anyplace along the gastrointestinal (GI) tract. The uncommon tumor location in groin area is rarely reported.Case presentationWe herein reported a metastasized case presented as GI hemorrhage complicated with indirect hernia, and underwent tumor cytoreduction, herniorrhaphy and chemotherapy for jejunal GIST. The case was described consecutively based on the process of surgical management, with a good follow-up result. A literature review by searching similar case reports from two national medical databases was performed to summarize clinical features of such unusual presentation of GIST, which included hernia characteristics, short- and long-term outcomes of this disease. It showed GIST presenting as groin hernia was rarely reported and all available 11 cases suggested a primary tumor and required both tumor resection and hernia repair. The long-term results indicated 64.3% overall survival at 5 years after the incidental diagnosis.ConclusionsInguinal hernia is an extremely rare presentation of GIST, with limited case reports available in the literature. A radical involving tumor resection plus hernia repair is an optimal surgical approach for such uncommon condition. An adjuvant medication mounting on mutated KIT gene should be strictly followed for high risk cases.
Highlights
Gastrointestinal stromal tumor (GIST) can arise anyplace along the gastrointestinal (GI) tract
An adjuvant medication mounting on mutated KIT gene should be strictly followed for high risk cases
The recent advances in tissue evaluation and molecular analysis have earned a deeper understanding of GIST lesion, which was considered as a disease arising from neurogenic or smooth muscle [1]
Summary
Primary or metastatic GIST could present with symptoms mimicking as a groin hernia. When diagnosing those unusual cases, physicians or surgeons should consider whether malignancy is present, among patients with a history of GIST. Abdominal and pelvic CT scans with enhanced contrast are effective tools for differential diagnoses and subsequent treatments. Never forget to check both groin areas when doing physical examination. Radical tumor resection plus tissue-free hernia repair is an optimal operation for an emergency case. An adjuvant medication targeted to the mutated KIT gene should be strictly followed for high-risk cases
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