Gastrointestinal Stromal Tumour of the Small Intestine – Case Report

Ema Dejhalla,Tina Zavidić

doi:10.29333/jcei/11270

Abstract

Gastrointestinal stromal tumours (GISTs) are mesenchymal tumours that can be located in any part of the gastrointestinal system. Most often they occur in the stomach and in 20-30% of cases they occur in the small intestine. About 30% of all GISTs are malignant. We report a case of a 54-year-old patient with malignant GIST located in the small intestine and liver. The patient complained of discomfort and heaviness in the abdomen and parts of the abdomen were hard on palpation. Family physician performed an ultrasound of the abdomen which showed a large mass in the right hemiabdomen. CT scan of the abdomen showed a tumour mass of approximately 13x19x20 cm and GIST was suspected. Biopsy was performed and histopathological finding spoke in favour of GIST. GIST resection and Meckel diverticulum resection were performed. Histopathological finding confirmed it was a malignant GIST. After nine months, a control ultrasound showed an oval formation of the liver and excision was performed. The patient was discharged home and histopathological finding confirmed that liver formations were also GIST. GIST should be considered as a possible cause of abdominal difficulties and the treatment of choice is surgery.

Highlights

Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract [1]
Gastrointestinal stromal tumours (GISTs) are mesenchymal tumours that can be located in any part of the gastrointestinal system
We report a case of a 54-year-old patient with malignant GIST located in the small intestine and liver

Summary

INTRODUCTION

Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract [1]. In 2018, the patient underwent total replacement of left hip, and a year later he had a pulmonary embolism He was diagnosed with genetic thrombophilia (heterozygous for PAI-1 4G / 5G) and was on anticoagulant therapy since. The patient was given a medication for hypertension and was ordered for a check-up in about 20 days Upon control, he stated that he still had erectile dysfunction, and a feeling of bloating, discomfort and heaviness in the abdomen. Over the few days, under ultrasound control, a biopsy of the tumour formation in the right iliac region was performed and a histopathological finding was obtained that spoke in favour of GIST. The histopathological finding of the resected part of the small intestine confirmed that it was a gastrointestinal stromal tumour, malignant. The patient will be further monitored in the oncology clinic

DISCUSSION

CONCLUSION

Findings

10. Atlas of Tumor Pathology