A Giant Jejunal Gastrointestinal Stromal Tumor Misconceived as Pancreatic Cystic Neoplasm : A case report

Abstract

Introduction: Gastrointestinal stromal tumors(GIST) are the most common mesenchymal tumors of the gastrointestinal tract. The most common site of these tumors is the stomach. Jejunal GIST is a rare type. This report describes a patient with large sporadic GIST in the proximal jejunum that mimicking the pancreatic cystic neoplasm by preoperative imaging study. Method: A 59-year-old Thai female presented with unexplained weight loss and palpable left upper abdominal mass for 6 months. Computed tomography of the abdomen demonstrated a heterogeneously enhanced mass at pancreatic body and tail measuring 10 cm in diameter. The mucinous cystadenoma was the preoperative diagnosis. The distal pancreatectomy and splenectomy were planned. Result: Laparotomy allowed the identification of extramural tumor originated from proximal jejunum and closed to the ligament of Treitz. The tumor just only abut the body of pancreas. Enbloc resection of the tumor with proximal jejunal segment were mandated. Conclusion: Finally, histopathological and immunohistochemical examination revealed this tumor was the GIST.