An unusual presentation of an extragastrointestinal stromal tumour: a case report

Abstract

Background: Gastrointestinal stromal tumours (GISTs) account for most mesenchymal gastrointestinal tumours, which in turn represent 1% of all gastrointestinal cancers. They mainly affect older adults, with a slight male preponderance. These lesions can be found along the digestive tract and most frequently in the stomach. Extragastrointestinal stromal tumours (EGISTs) are even rarer lesions, with few cases or series reported. Case presentation: A 51-year-old woman was referred to our hospital due to progressive abdominal volume increase. Evaluation by multidetector computed tomography (MDCT) revealed a large intraperitoneal mixed tumour with few solid components, measuring up to 30 cm and compressing the surrounding structures, thought to be an ovarian tumour. Diagnostic laparotomy showed that the lesion was adherent to the greater gastric curvature and the vesical peritoneum. The lesion was removed without complications. Conclusions: Imaging plays an essential role in the diagnosis of large intraperitoneal tumours. MDCT is the preferred technique to stage and to follow-up EGISTs.

Gastrointestinal stromal tumour: presenting as an ovarian cystadenoma

“…The number of cases per million people varies between 11 and 15 6 9. GISTs can develop sporadically at any age, with slightly more occurrence in men than in women 2. In children and adolescents, the succinate dehydrogenase (SDH) mutant type of GIST occurs mostly in the stomach with a female preponderance 3 4 6…”

“…Gastrointestinal stromal tumours (GISTs) are frequent mesenchymal tumours of the gastrointestinal (GI) tract, which evolve from the so-called ‘pacemaker’ of the digestive system—the interstitial cells of Cajal 1 2. Men in their middle years tend to have them the most 2. In 40%–60% of cases, they are in the stomach, 25%–30% in the jejunum/ileum, 5% in the duodenum and 5%–15% in the colorectum 2 3.…”

“…Men in their middle years tend to have them the most 2. In 40%–60% of cases, they are in the stomach, 25%–30% in the jejunum/ileum, 5% in the duodenum and 5%–15% in the colorectum 2 3. Less than 5% of GIST develops outside the GI tract, including in the pharynx, mediastinum omentum, mesentery, liver, gall bladder, pancreas, retroperitoneum, abdominal wall and peri-vesical tissue 4–6.…”

“…Less than 5% of GIST develops outside the GI tract, including in the pharynx, mediastinum omentum, mesentery, liver, gall bladder, pancreas, retroperitoneum, abdominal wall and peri-vesical tissue 4–6. Inadvertently discovered during surgery or radiological examinations, GISTs are frequently identified as isolated lesions that might vary from less than 1 cm to 30 cm in size 2 3. Small-bowel GISTs are more frequently diagnosed when they are large and present with complications such as bowel obstruction, viscus perforation, bleeding and ulceration 1 2 5.…”

“…Inadvertently discovered during surgery or radiological examinations, GISTs are frequently identified as isolated lesions that might vary from less than 1 cm to 30 cm in size 2 3. Small-bowel GISTs are more frequently diagnosed when they are large and present with complications such as bowel obstruction, viscus perforation, bleeding and ulceration 1 2 5. They usually present as an abdominal mass and less commonly present as a pelvic mass that might mimic an ovarian adnexal tumour radiologically, especially when they compress atrophic adnexal structures in an elderly woman.…”