Une tumeur stromale (GIST) gastrique exophytique révélée par un abdomen aigu: une présentation extrêmement rare. À propos d’un cas

Abstract

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasia of the gastrointestinal tract. The gastric presentation is the most frequent (60–70%) followed by the small intestine presentation (20–30%). GISTs have typical immunohistochemical features which are essential for diagnosis. About 95% of GISTs are positive for c-KIT expression (CD117 antigen), a transmembrane tyrosine kinase receptor which activation leads to cell proliferation. Surgery is the treatment of choice for resectable tumours, whereas for unresectable tumours the standard treatment is the administration of imatinib (Glivec®), a c-KIT/PDGFRA competitive inhibitor. Response rate to imatinib treatment is about 80%. GIST diagnosis might be incidental or due to the appearance of aspecific symptoms such as abdominal pain, abdominal mass or gastrointestinal bleeding. Rupture in the peritoneal cavity with peritonitis represents a very rare event and very few cases of generalized peritonitis as initial presentation of GIST, are reported in the literature.We report here an unusual case of gastric GIST presenting with generalized peritonitis due to spontaneous rupture in the abdominal cavity.