Spontaneous rupture of a giant gastrointestinal stromal tumor of the jejunum: a case report and literature review

World Journal of Surgical Oncology

Case Report

Hiroyoshi Ota¹  Shun-ichi Misawa²  Hiroto Sakamoto²  Yasushi Kirii²  Hiroyuki Takagi²  Misuzu Takeda² 

[1] Department of Biomedical Laboratory Sciences, Shinshu University, School of Medicine, School of health Science, 3-1-1 Asahi, 390-8621, Matsumoto, Nagano, Japan;Department of Surgery, Matsumoto City Hospital, 4417-180 Hata, 390-1401, Matsumoto, Nagano, Japan;

关键词: Imatinib;    Gastrointestinal Stromal Tumor;    Peritoneal Metastasis;    Spontaneous Rupture;    Central Necrosis;   

DOI  :  10.1186/1477-7819-12-153

 received in 2013-12-17, accepted in 2014-05-02,  发布年份 2014

来源: Springer

【 摘 要 】

A few cases of a gastrointestinal stromal tumor (GIST) of the small intestine presenting as rupture have been reported in the medical literature. We report an unusual case of a large GIST of the jejunum that presented as a spontaneous rupture. A 70-year-old man was referred to our hospital because of fever and abdominal pain. An abdominal enhanced computed tomography (CT) scan detected a 10-cm tumor with heterogeneous staining, suggesting necrosis or abscess inside the tumor. The patient was treated with antibiotics but inflammation persisted and an operation was performed. Intraoperative findings showed an outgrowing 10-cm mass in the jejunum near Treitz's ligament. The tumor had ruptured with peritoneal metastasis. The solid parenchyma contained a focal area of necrosis within and the small ulcer located in the wall of the jejunum presented a communication with the large tumor cavity. H&E staining showed spindle-shaped cell proliferation, and immunohistochemical staining showed results positive for c-kit and CD34. The patient received a diagnosis of a GIST (high-risk group) of the jejunum and was treated with imatinib mesylate. The patient has remained in good health without recurrence or metastasis one year after the surgical procedure.

【 授权许可】

CC BY   
© Misawa et al.; licensee BioMed Central Ltd. 2014