DOI QR코드

DOI QR Code

Gastrointestinal Stromal Tumor of the Stomach Presenting as Multilobular with Diffuse Calcifications

  • Kim, Sae Hee (Department of Internal Medicine, Eulji University Hospital) ;
  • Lee, Moon-Soo (Department of Surgery, Eulji University Hospital) ;
  • Cho, Byung Sun (Department of Surgery, Eulji University Hospital) ;
  • Park, Joo-Seung (Department of Surgery, Eulji University Hospital) ;
  • Han, Hyun-Young (Department of Radiology, Eulji University Hospital) ;
  • Kang, Dong-Wook (Department of Pathology, Eulji University Hospital)
  • Received : 2016.01.04
  • Accepted : 2016.03.06
  • Published : 2016.03.31

Abstract

Gastrointestinal stromal tumors (GISTs) are the most common primary mesenchymal neoplasms of the gastrointestinal tract and usually appear as a well-circumscribed mass. However, it may be difficult to confirm the extent of the disease for some GISTs. A 70-year-old asymptomatic female presented for a regular physical exam. An esophagogastroduodenoscopy showed a 2.0 cm protruding mass on the gastric fundus. Endoscopic ultrasound revealed an ill-defined heterogenous hypoechoic lesion ($3.0{\times}1.5cm$). A computed tomography (CT) scan demonstrated a 4.5 cm multifocal calcified mass at the gastric body as well as at the gastric fundus. Laparoscopic gastric wedge resection was performed according to the extent of multifocal calcifications that are shown on the CT. Intraoperative specimen mammography and intraoperative biopsy might be helpful to obtain a tumor-free margin. Final pathologic diagnosis was an intermediate risk GIST in multilobular form. In patients with diffuse multifocal calcifications in the stomach, the possibility of GIST should be considered.

Keywords

References

  1. Nishida T, Hirota S. Biological and clinical review of stromal tumors in the gastrointestinal tract. Histol Histopathol 2000;15:1293-1301.
  2. Cho MY, Sohn JH, Kim JM, Kim KM, Park YS, Kim WH, et al. Current trends in the epidemiological and pathological characteristics of gastrointestinal stromal tumors in Korea, 2003-2004. J Korean Med Sci 2010;25:853-862. https://doi.org/10.3346/jkms.2010.25.6.853
  3. Agaimy A, Wunsch PH. Gastrointestinal stromal tumours: a regular origin in the muscularis propria, but an extremely diverse gross presentation. A review of 200 cases to critically reevaluate the concept of so-called extra-gastrointestinal stromal tumours. Langenbecks Arch Surg 2006;391:322-329. https://doi.org/10.1007/s00423-005-0005-5
  4. Levy AD, Remotti HE, Thompson WM, Sobin LH, Miettinen M. Gastrointestinal stromal tumors: radiologic features with pathologic correlation. Radiographics 2003;23:283-304. https://doi.org/10.1148/rg.232025146
  5. Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, et al. Diagnosis of gastrointestinal stromal tumors: a consensus approach. Hum Pathol 2002;33:459-465. https://doi.org/10.1053/hupa.2002.123545
  6. Chourmouzi D, Sinakos E, Papalavrentios L, Akriviadis E, Drevelegas A. Gastrointestinal stromal tumors: a pictorial review. J Gastrointestin Liver Dis 2009;18:379-383.
  7. Ghahremani GG, Meyers MA, Port RB. Calcified primary tumors of the gastrointestinal tract. Gastrointest Radiol 1978;2:331-339.
  8. Ghanem N, Altehoefer C, Furtwangler A, Winterer J, Schafer O, Springer O, et al. Computed tomography in gastrointestinal stromal tumors. Eur Radiol 2003;13:1669-1678. https://doi.org/10.1007/s00330-002-1803-6
  9. Rege TA, Wagner AJ, Corless CL, Heinrich MC, Hornick JL. "Pediatric-type" gastrointestinal stromal tumors in adults: distinctive histology predicts genotype and clinical behavior. Am J Surg Pathol 2011;35:495-504. https://doi.org/10.1097/PAS.0b013e31820e5f7d
  10. Blay JY, Bonvalot S, Casali P, Choi H, Debiec-Richter M, Dei Tos AP, et al; GIST consensus meeting panelists. Consensus meeting for the management of gastrointestinal stromal tumors. Report of the GIST Consensus Conference of 20-21 March 2004, under the auspices of ESMO. Ann Oncol 2005;16:566-578. https://doi.org/10.1093/annonc/mdi127
  11. Rutkowski P, Nowecki ZI, Michej W, Debiec-Rychter M, Wozniak A, Limon J, et al. Risk criteria and prognostic factors for predicting recurrences after resection of primary gastrointestinal stromal tumor. Ann Surg Oncol 2007;14:2018-2127. https://doi.org/10.1245/s10434-007-9377-9

Cited by

  1. Laparoscopic total gastrectomy for a giant gastrointestinal stromal tumor (GIST) with acute massive gastrointestinal bleeding: a case report vol.12, pp.3, 2017, https://doi.org/10.5114/wiitm.2017.67997