Synchronous Duodenal and Jejunal Gastrointestinal Stromal Tumors

Abstract

BACKGROUND Gastrointestinal stromal tumor (GIST) constitutes up to 1% of all malignant neoplasms of the gastrointestinal tract, with the stomach and small intestine being the most frequently affected organs. The purpose of this report is to present the first published case of synchronous duodenal and jejunal GISTs. CASE REPORT A 57-years old male patient with type II diabetes complained of asthenia and vertigo, resulting from anemia. On upper digestive endoscopy, a friable lesion was found in the second portion of the duodenum. The biopsy diagnosed GIST and its removal was indicated. During the surgical procedure, a second tumor was found in the jejunum, which was also removed. Anatomopathological examination of this second lesion also revealed GIST with the same cytological features. Digestive reconstruction was performed in Roux-en-Y of the jejunum sectioned distally to the tumor with the open part of the duodenum. The patient evolved without complications, was discharged on the third postoperative day and has been followed up for eleven years without any other treatment and without neoplastic recurrence. Food transit occurs almost exclusively through the duodenum. CONCLUSION This is the first report of two synchronous GISTs of duodenum and jejunum. After removal of both tumors, the Roux-en-Y reconstruction adequately closed the opened duodenum, but food transit persisted physiological through the duodenum.