Intestinal Preserving Giant Mesenteric GIST Excision – A Rare Case

Abstract

Gastrointestinal Stromal Tumors (GISTs) were originally believed to have originated from the mesenchymal cells of the gastrointestinal tract. These tumors actually originate from the intestinal cells of Cajal. A 26-year-old female came with complaints of mass per abdomen since 3 months which was insidious in onset, slowly progressive, complaining of vomiting,3-4 episodes since the last 4 days, non-blood tinged,non-projectile,non-bilious,non-foul smelling containing food particles associated with pain in the upper abdomen dull aching type,non-radiating, and non-migrating. On per abdominal examination — There was an oval-shaped mass that was firm in consistency, measuring about 15x10cm in size located in the left lumbar extending into the umbilical area which was mobile horizontally but vertical mobility was restricted. Routine investigations, USG, and CECT abdomen & pelvis were done which was pointing the diagnosis towards mesenteric GIST. Exploratory laparotomy and resection of GIST were scheduled. The resected tumor was sent for histopathological examination and a CD-117(IHC) marker was sent, which confirmed the mass as a mesenteric GIST. Literature shows that only a few cases of mesenteric GIST have been reported to date. Incidence of such giant mesenteric GISTs is very rare and intestinal preserving giant mesenteric gist excision is one of the firsts. Keywords: Mass per abdomen, Mesenteric GIST