Asymptomatic large duodenal GIST – An incidental finding in abdominopelvic ultrasonography: A case report

Abstract

IntroductionDuodenal GISTs are rare mesenchymal tumors of the digestive tract. They usually present as gastrointestinal bleeding or non-specific abdominal pain, but they can also be asymptomatic. High-risk GISTs have malignant potential. Surgical resection is the only curative option and its extension depends on different factors. Tyrosine kinase inhibitors are of the utmost importance in high-risk and metastatic disease. Case descriptionWe herein report the case of a 75-year-old male, referred to our general surgery outpatient clinic, with an asymptomatic duodenal mass incidentally diagnosed during an abdominopelvic ultrasonography. Abdominal CT suggested GIST. Since no other lesions were found, a segmental duodenectomy was performed and the patient recovery was uneventful. Histologic exam confirmed the presence of a high-risk GIST, therefore adjuvant therapy with imatinib was initiated. DiscussionDuodenal involvement by GISTs is rare, even more in its third/fourth portions. The widespread clinical use of radiological exams such as ultrasonography may lead to the diagnosis of asymptomatic masses. Surgical treatment is the gold-standard giving the malignant potential of these neoplasms. There are risk stratification scores that may be used to assess the need for adjuvant therapy. ConclusionEven large GISTs can by asymptomatic. Giving their malignant potential, early diagnosis and treatment are crucial. The histologic findings and genetic profile have an impact on the patient’s survival.