Pancreatic Extra-Gastrointestinal Stromal Tumour Presenting as an Intra-Abdominal Abscess: A Case Report and Literature Review

Abstract

Introduction: Pancreaticoduodenectomy is one of the most frequently performed operations for pancreatic lesions around the world. Some pancreatic malignancies are particularly rare and difficult to diagnose preoperatively. Gastrointestinal stromal tumour is a common mesenchymal neoplasm of the gastrointestinal tract rarely found outside its boundaries. We report a case of a patient who presented to our hospital with a large intra-abdominal abscess with a unique post operative pancreatic extra-gastrointestinal stromal tumour (EGIST) as the final pathology. Presentation of case: We report a -32 year- old female who was admitted through the emergency department complaining of epigastric pain of one-week duration associated with spikes of fever and anorexia. The performed investigations manifest a large mass with infected central necrosis. The patient was managed initially with percutaneous drainage and intravenous antibiotics. Two weeks later the patient underwent whipple’s procedure and was discharged home uneventfully. The final histological report came as pancreatic extra-gastrointestinal stromal tumour. Discussion: Primary EGISTs outside the gastrointestinal tract are quite rare and account for up to 5%. It can originate from any mesenchymal organ. Primary pancreatic EGIST is a distinctly and extremely rare tumour. only few cases have been reported in the literature. Conclusion: Despite the rarity of this type of malignancy involving the pancreas, all hepatobiliary surgeons should keep it in mind as a possible pathology. Much effort must be done to make the diagnosis preoperatively apart from emergency presentation. Large pancreatic tumours with necrosis or cystic degeneration should ignite the suspicion of EGIST.Tabled 1Histology reportCD117+CD34+Desmin-Synaptophysin-Chromogranin-Lymph N14 reactive Open table in a new tab