Abstract
Gastrointestinal stromal tumours (GISTs) are considered the most common mesenchymal neoplasms of the alimentary tract, yet they account for only 0.2% of all gastrointestinal neoplasms.We are presenting a case of a 68-year-old gentleman who was diagnosed with a 250 mm jejunal GIST only when he presented with abdominal pain and fullness in the upper abdomen. We believe that detailed medical history, followed by prompt investigations, will help in early diagnosis of small GISTs with less malignant potential, which in turn will lead to better outcomes.
Highlights
Mazur and Clark were the first to describe gastrointestinal stromal tumours (GISTs) in 1983 as rare mesenchymal tumours of the alimentary tract [1]
In spite of the fact that most GISTs present with acute or chronic gastrointestinal bleeding, or unexplained anaemia, we are presenting a case of a gentleman who was only diagnosed with huge jejunal GIST when he presented with abdominal pain and fullness
His laboratory investigations were normal; given the palpable mass, a CT scan of the abdomen and pelvis was carried out which showed a large tumour arising from the proximal jejunum with no signs of obstruction (Figures 1, 2)
Summary
Mazur and Clark were the first to describe gastrointestinal stromal tumours (GISTs) in 1983 as rare mesenchymal tumours of the alimentary tract [1]. We are presenting a case of a 68-year-old man who presented to the local accident and emergency department with abdominal pain and distension. Abdominal examination revealed a tender, palpable mass in the epigastric region, which is even visible with inspection when the patient lies flat. His laboratory investigations were normal; given the palpable mass, a CT scan of the abdomen and pelvis was carried out which showed a large tumour arising from the proximal jejunum with no signs of obstruction (Figures 1, 2). Postoperative histology confirmed the mass to be a fully resected GIST, with mitotic count > 5/50 high power field (HPF); based on the size and the high mitotic count, imatinib was prescribed to the patient
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