Rare case of gastrointestinal bleeding: jejunal gastrointestinal stromal tumor
DOI:
https://doi.org/10.18203/2349-2902.isj20210947Keywords:
GIST, Jejunum, Imatinib mesylateAbstract
Gastrointestinal stromal tumours (GIST) are mesenchymal or non-epithelial neoplasms of gastrointestinal tract, with most common GI location being stomach (60%), followed by small intestine (30%), colon, rectum and oesophagus. Occurrence of GIST in jejunum is rare. Here we report a rare case of a 45 years old post-menopausal woman with pain abdomen, vomiting, malena and anemia who underwent laparotomy with resection of the tumour and anastomosis. Intra-operative findings revealed a 10x8 cms exophytic mass at the mesenteric end of the proximal jejunum, 10 cms from the DJ flexure. Diagnosis was confirmed by histopathological examination and immunohistochemistry (CD117). Patient had an uneventful postoperative course.
References
Kindblom LG, Remotti HE, Aldenborg F, Meis-Kindblom JM. Gastrointestinal pacemaker cell tumor (GIPACT): gastrointestinal stromal tumors show phenotypic characteristics of the interstitial cells of Cajal. Am J Pathol. 1998;152(5):1259-69.
Mahmoud S, Salman H, Salami M. A rare case report of locally recurrent hemorrhagic duodenal gastrointestinal stromal tumor: therapeutic challenges and review of prognostic indicators for recurrence. J Surg Case Rep. 2020;1:1-4.
Kramer K, Siech M, Sträter J, Aschoff AJ, Henne-Bruns D. “GI hemorrhage with fulminant shock induced by jejunal gastrointestinal stromal tumor (GIST) coincident with duodenal neuroendocrine carcinoma (NET) + neurofibromatosis (NF)-Case report and review of the literature”. Zeitschrift für Gastroenterologie. 2005;43(3):281-8.
Govindaraj S, Dias BH, Gautham SL. A sporadic small jejunal GIST presenting with acute lower gastrointestinal hemorrhage: a review of the literature and management guidelines. Indian J Surg. 2015;77(1):143-6.
Melo C. Surgical treatment of giant GIST with acute gastrointestinal bleeding: case report. Int J Surg. 53 2018;354-7.
Dhull AK, Kaushal V, Dhankhar R, Atri R, Singh H, Marwah N. The Inside Mystery of Jejunal Gastrointestinal Stromal Tumor: A Rare Case Report and Review of the Literature. Case Rep Oncol Med. 2011;2011:1-4.
Nizami A, Goel AK, Rama P, Kumar N, Agarwal E, Biradar KI, et al. Jejunal Gist - A Rare Presentation of Obscure GI Bleed. J Dental Med Sci. 2016;15:89-93.
Perry CG, Young WF, McWhinney SR, Bei T, Stergiopoulos S, Knudson RA, et al. Functioning paraganglioma and gastrointestinal stromal tumor of the jejunum in three women: syndrome or coincidence. Am J Surg Pathol. 2006;30(1):42-49.
Barbu LA, M˘arg˘aritescu ND, Ghilusi MC, Belivac˘a D, Georgescu EF, Ghelase M, et al. Severe upper gastrointestinal bleeding from gastrointestinal stromal tumor of the stomach. Rom J Morphol Embryol. 2016;57(4):1397-401.
Khuri S, Gilshtein H, Darawshy A, Bahouth H, Kluger Y. Primary smallbowel GIST presenting as a life-threatening emergency: a report of two cases. Case Rep Surg. 2017;5:1814254.
Nizami A, Goel AK, Rama P, Kumar N, Agarwal E, Biradar KI, et al. Jejunal Gist - A Rare Presentation of Obscure GI Bleed. 2016;15:89-93.
Armbrust T, Sobotta M, Ramadori G. “Follow up of three cases after adjuvant treatment of high risk gastrointestinal stromal tumors with Imatinib. Annals Oncology. 2007;18(6):1123-5.
Parab TM, Rogatis DMJ, Boaz AM, Grasso SA, Issack PS, Duarte DA, et al. Gastrointestinal stromal tumors: A comprehensive review. J Gastrointestinal Oncology. 2019;10:144-54.
Barnes G, Bulusu VR, Hardwick RH, Carroll N, Hatcher H, Earl HM, et al. A review of the surgical management of metastatic gastrointestinal stromal tumours (GISTs) on imatinib mesylate (Glivec TM). Int J Surg. 2005;3:206-12.
