Primary Liver GIST Presenting as a Persistent Liver Abscess

Abstract

Introduction: Primary liver GIST are very rare, there are only 34 cases reported in the literature; their origin is unknown but may be related to intersticial Cajal-like cells or from undifferentiated pluripotent mesenchymal stem cells that differentiate to the former. Methods: We present a case of a 56 year old woman that presented with a 4 day historia of abdominal pain with no other symptoms, liver tests, inflamatory markers and tumor markers where unremarkable. She has been previously been hospitilized for what appeared yo be a liver abscess wich was drained percutaneosly, and given a 4 week course of antibióticos. Results: Current imaging included CT that showed an ill defined cystic non-enhancing lesión in segments VI,V and VII of 8x6x7cm. MRI showed the same lesion with ill defined enhancement with contrast that suggested a liver neoplasic lesion. With this results a percutaneous liver biopsy was done that was compatible with a GIST tumor. Upper endoscopy and colonoscopy where negative, and because the patient persisted symptomatic an open liver resection of segments VI,V and VI was done, no other lesions where seen in the abdomen. Operative time was 240 minutes, 500cc blood loss, 3 postiperative days in the ICU and 5 days in the floor until discharge, no periopetative morbidity; follow up, was unremarkable awaiting Oncology consult to decide adyuvant treatment.PET-FDG scan was done wich was negative for malignant lesions. Conclusion: Primary liver GIST is very rare entity ; this report contributes to the understanding and presentation for ungoing studies.