A rare cause of gastrointestinal bleeding in paediatric age

Abstract

A 14-year-old adolescent girl presented after an episode of synope preceded by two consecutive episodes of melena. Physical xamination results were normal. Routine biochemistry revealed icrocytic anaemia (haemoglobin 7.5 g/dL, MCV 74 fl), while comlete metabolism profile and coagulation parameters were all ithin normal limits. She was transfused with 2 units of packed ed blood cells, and an urgent esophagogastroduodenoscopy was erformed. Esophagogastroduodenoscopydemonstrated 3 submuosal sessile masses in the gastric antrum ranging from 1 to 3 cm ith normal overlying mucosa except for one of the lesions, which as ulcerated (Fig. 1). Endosonographic imaging demonstrated multilobular, homogeneous and hypoechoic lesion originating rom the muscularis propria, with regular outer borders, without ymph node involvement (Fig. 2). Contrast-enhanced CT scan of the bdomen demonstrated no other focal lesions. Endoscopic biopsies tained positive for CD117 and were consistent with GIST. Total excision of the gastric lesion with partial gastrectomy was erformed. The patient has had no signs of recurrence during 6 onths of follow-up. Gastrointestinal stromal tumours (GISTs) are mesenchymal umours of the intestinal tract that typically occur in adults over he age of 40 years. GIST in younger patients are rare and their ehaviour is notoriously difficult to predict. Typically with GIST, sophagogastroduodenoscopy will demonstrate a normal surface ucosa and a firm, smooth yellowish submucosal mass, which can e ulcerated. In some cases these tumours can be missed because f their frequent submucosal and extraluminal growth [1,2]. This ase, to our knowledge, is one of the rare reports of the endoscopic ppearance of GIST in a paediatric patient. Although a rare entity n children, GIST should be considered in paediatric patients with ndoscopically visualised submucosal gastric masses.