Abstract
Gastrointestinal stromal tumor (GIST) is a rare stromal neoplasm, which represents the most common mesenchymal tumor of the gastrointestinal tract. It is characterized by indolent clinical symptoms, although it can present as a life-threatening emergency. Herein, we present two cases of primary small bowel GIST treated at our department. A 68-year-old female patient presented to our emergency department with a diffuse abdominal pain of acute onset. Imaging studies revealed a mass at proximal jejunum, with a nearby free air and fluid. At surgery, a mass of 9 cm was found at proximal jejunum, 3 cm distal to the treitz ligament, with perforation on the lateral wall of the mass. En bloc resection was performed. Pathology report was positive for gastrointestinal stromal tumor. A 70-year-old male patient presented to our emergency department with 3 days of dark tarry stool and few hours of hematochezia. Computed tomography angiography revealed a mass at the pelvis, with calcifications, attached to the distal ileum, with intraluminal blush of intravenous iodine. At surgery, a mass of 8 cm at the distal ileum was found. Resection of the mass along with a 20 cm of ileum was completed. Histopathology report was positive for malignant gastrointestinal stromal tumor.
Highlights
Gastrointestinal stromal tumor (GIST), first described by Mazur and Clark (1983) [1], is the most common mesenchymal neoplasm of the GI tract; it accounts for less than 1% of all GI tumors [2]
We describe two emergency cases of small bowel GIST treated at our department
A computed tomography scan revealed a hypodensic mass of 9.5 ∗ 6.4 cm at proximal jejunum leading to narrowing of the lumen, with a nearby free air and fluid, small amount of fluid at the pelvis, and multiple hypodensic masses at right liver (Figure 1)
Summary
Gastrointestinal stromal tumor (GIST), first described by Mazur and Clark (1983) [1], is the most common mesenchymal neoplasm of the GI tract; it accounts for less than 1% of all GI tumors [2]. It originates from the interstitial cells of Cajal, which are part of the autonomic nervous system of the intestine [3]. GISTs (mainly tumors larger than 4 cm) may present as abdominal emergencies, including GI hemorrhage, usually due to pressure necrosis and ulceration of the overlying mucosa, intestinal obstruction, or perforation.
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