Abstract
BackgroundGastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. Rectal locations are very rare, and minimally invasive surgery is a good choice for the treatment of rectal GISTs.Case presentationTwo women each had a mass located on the lower vaginal-rectal space as determined by transvaginal ultrasound (TV-US), pelvis MR imaging, and colonoscopy. The patients successfully underwent transvaginal excision. The spindle-shaped cells were found in pathological test. The immunohistochemical analysis showed that CD117 and Dog-1 were stained positively. These results confirmed the masses as GISTs. The postoperative period was uneventful without anal dysfunction. Two patients were received adjuvant treatment with imatinib after surgery.ConclusionTransvaginal excision could be a minimally invasive and safe alternative treatment in the management of rectal GISTs in lower locations.
Highlights
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract
Rectal GISTs, especially those located in the lower rectum, are detected upon expansion of the posterior wall of the vagina during a gynecological examination in females
The approach of minimally invasive surgery that we choose for rectal GIST patients depends on the tumor pathology, volume, location, and the surgeon’s skills
Summary
Gastrointestinal stromal tumors (GISTs) are a common type of mesenchymal tumors. The common sites of origination are the stomach (60–70%) and intestines (20–30%) [1, 2]. The results of histological examination showed that the tumor was positive for CD117, Dog-1, and CD34 (Fig. 3c, e) These findings suggest a moderaterisk rectal GIST that required follow-up. She had not suffered any anal dysfunction nor postoperative vaginal-rectal fistula She refused to undergo enlarged resection but received imatinib treatment after surgery. The results of postoperative histological examination showed that the tumor was resected with clear margin (Fig. 6c). They were coherent with the results of preoperative biopsy. She refused radical resection but received imatinib treatment after surgery.
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