Acta Scientific Gastrointestinal Disorders (ASGIS)(ISSN: 2582-1091)

Case Report Volume 4 Issue 6

Giant GIST of the Stomach Masquerading Gigantic Cyst Located in the Upper Part of the Peritoneal Cavity

Ramiz B Bayramov*, Ramila T Abdullayeva and Simara E Huseynova

Department of Oncology, Azerbaijan Medical University, Baku, Azerbaijan

*Corresponding Author: Ramiz B Bayramov, Department of Oncology, Azerbaijan Medical University, Baku, Azerbaijan.

Received: April 22, 2021; Published: May 11, 2021

Abstract

  Gastrointestinal stromal tumors (GISTs) are uncommon when compared to all gastrointestinal neoplasms but are the most common (80 - 85%) and specific mesenchymal tumors of the gastrointestinal tract. GISTs often present solid tumors and are rarely predominantly cystic. This report presents a case of a large exophytic cystic GIST in 61-year-old woman who was referred to specialized oncologic clinic from an unspecialized hospital with a suspicion of huge pancreatic cystic lesion based on CT imaging. A multidisciplinary meeting including gastrointestinal surgical oncologists, endoscopists and radiologists was held before operation and gastric GIST with cystic appearance was highly doubtful as a definite preoperative clinicoradiologic diagnosis. Radiologically other cystic lesions were less doubtful. Taking into consideration the possible clinicoradiological diagnosis surgery was planned. At laparotomy a large exophytic cystic mass was found to be attached by a thin (3.0 cm in diameter) stalk to the greater curvature of the stomach at the level of its upper third. No infiltration into the surrounding structures was observed. The cyst was very mobile and did not attach to adjacent anatomical structures by adhesions. The lowermost pole of the lesion was at the level lower than umbilicus. The size of the mass was 18 × 17 × 10 cm. Wedge resection of the greater curvature of the stomach along with the cystic mass and the adherent greater omentum was performed. Pathology confirmed spindle cell tumor. Mitotic index was ≤ 5/50 HPFs and the tumor cells demonstrated positivity for CD117 on immunohistochemical staining. The histological features together with the immunohistochemical profile of the tumor cells were consistent with the GISTs. The tumor was accepted as GIST of the stomach with high risk of recurrence according to the generally accepted classifications. Patient was administrated imatinib for 12 months and during the 16 months’ postoperative period no local recurrence or metastases were detected.

Keywords: GIST; Gastric Cancer; Intraabdominal Cyst

References

  1. Mohamed A., et al. “Gigantic GIST: a case of the largest gastrointestinal stromal tumor found to date”. Case Reports Surgery (2018): 6179861.
  2. Nishida T and Hirota S. “Biological and clinical review of stromal tumours in the gastrointestinal tract”. Histology and Histopathology4 (2000): 1293-1301.
  3. Tran T., et al. “The epidemiology of malignant gastrointestinal stromal tumors: an analysis of 1,458 cases from 1992 to 2000”. American Journal of Gastroenterology 1 (2005): 162-168.
  4. Zhao X and Yue Ch. “Gastrointestinal stromal tumor”. Journal of Gastrointestinal Oncology 3 (2012): 189-208.
  5. Ferreira SS., et al. “Synchronous gastrointestinal stromal tumors (GIST) and other primary cancers: Case series of a single institution experience”. International Journal of Surgery 4 (2010): 314-317.
  6. Demetri GD., et al. “NCCN task force report: update on the management of patients with gastrointestinal stromal tumors”. Journal of the National Comprehensive Cancer Network 2 (2010): S1-S41.
  7. Hamza AM., et al. “Gastrointestinal stromal tumour masquerading as a cyst in the lesser sac”. BMJ Case Reports (2016): bcr-2016-215479.
  8. Okano H., et al. “A case of a stomach gastrointestinal stromal tumor with extremely predominant cystic formation”. Clinical Journal of Gastroenterology 4 (2015): 197-201.
  9. Wang L., et al. “Giant gastrointestinal stromal tumor with predominantly cystic changes: a case report and literature review”. World Journal of Surgical Oncology 15 (2017): 220-223.
  10. Levy AD., et al. “Gastrointestinal stromal tumors: radiologic features with pathologic correlation”. Radiographics2 (2003): 283-304.
  11. DeMatteo R P., et al. “Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival”. Annals of Surgery 1 (2000): 51-58.
  12. Hirota S., et al. “Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors”. Science5350 (1998): 577-580.
  13. Miettinen M and Lasota J. “Gastrointestinal stromal tumors—definition, clinical, histological, immunohistochemical, and molecular genetic features and differential diagnosis”. Virchows Archiv 1 (2001): 1-12.
  14. Koelz M., et al. “The impact of c-kit mutations on histomorphological risk assessment of gastrointestinal stromal tumors”. European Surgery1 (2007): 45-53.
  15. De Vogelaere K., et al. “Unusual Appearance of a Pendulated Gastric Tumor: Always Think of GIST”. Case Reports in Surgery (2012): 815941.
  16. Hansen CA., et al. “Gastrointestinal stromal tumor (GIST) mistaken for pancreatic pseudocyst-case report and literature review”. Clinical Case Reports 5 (2014): 197-200.
  17. Streutker CJ., et al. “Interstitial cells of Cajal in health and disease. Part II: ICC and gastrointestinal stromal tumours”. Histopathology 2 (2007): 190-202.
  18. Miettinen M., et al. “Pathology and diagnostic criteria of gastrointestinal stromal tumors (GISTs): a review”. European Journal of Cancer 5 (2002): S39-S51.
  19. Cappellani A., et al. “Giant gastrointestinal stromal tumor (GIST) of the stomach cause of high bowel obstruction: surgical management”. World Journal of Surgical Oncology 11 (2013): 172-176.
  20. Joensuu H., et al. “Risk of recurrence of gastrointestinal stromal tumour after surgery: an analysis of pooled population-based cohorts”. Lancet Oncology3 (2012): 265-274.
  21. DeMatteo RP., et al. “Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival”. Annals of Surgery 1 (2000): 51-58.
  22. Zhu CC., et al. “Exophytic gastrointestinal stromal tumor with cystic changes: a case report”. Oncology Letters 5 (2014): 1427-1429.
  23. Kumar A., et al. “Atypical presentation of gastrointestinal stromal tumor masquerading as a large duodenal cyst: a case report”. International Journal of Surgery Case Reports 9 (2015): 123-126.
  24. Joensuu H and DeMatteo RP. “The management of gastrointestinal stromal tumors: a model for targeted and multidisciplinary therapy of malignancy”. Annual Review of Medicine 63 (2012): 247-258.

Citation

Citation: Ramiz B Bayramov., et al. “Giant GIST of the Stomach Masquerading Gigantic Cyst Located in the Upper Part of the Peritoneal Cavity”. Acta Scientific Gastrointestinal Disorders 4.6 (2021): 23-27.

Copyright

Copyright: © 2021 Ramiz B Bayramov., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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