Gastrointestinal stromal tumor arising in the rectovaginal septum

Abstract

We report herein a rare case of malignant gastrointestinal stromal tumor (GIST) originated from the rectal wall, which presented as a tumor on the rectovaginal septum. A 54-year-old Japanese woman, gravida 4, para 3, was admitted complaining of anuresis and severe constipation. She had a history of hysterectomy and right salpingo-oophorectomy for uterine leiomyoma 11 years previously. Pelvic examination revealed an 8.5 x 7.5 x 7.5 cm hard mass in the rectovaginal space. The inferior border of the tumor was 2 cm from the vaginal introitus and 2 cm from the anus. Computed tomography and magnetic resonance imaging showed a well-circumscribed soft-tissue mass filling the rectovaginal space. Urinary bladder and rectum were markedly compressed and displaced. Colon fiberscopy revealed invasion of the tumor into the rectal mucosa. An abdominoperineal resection of the rectum with posterior vaginal wall resection and pelvic lymphadenectomy was performed. The resected specimen showed a rectal submucosal tumor that was 8 x 8 x 7 cm in size. The tumor was diagnosed as a malignant GIST. Immunohistochemical analysis confirmed this diagnosis. The patient is now healthy without evidence of recurrence at 13 months after surgery. Gynecologists should be aware of rectal GIST arising in the rectovaginal space as a differential diagnosis of vaginal submucosal tumor.

Mutational spectrum and therapy response of metastasized GIST in Central Switzerland – A population-based study

“…Until now only a few cases of GIST in the rectovaginal septum have been described in the English literature (20)(21)(22)(23)(24)(25)(26)(27)(28)(29). In all these reports, similarly to our case, this localization seems to be associated with a favourable prognosis.…”

A Hemodialysis Patient with Primary Extra-gastrointestinal Stromal Tumor: Favorable Outcome with Imatinib Mesylate

“…GISTs are estimated to occur in 0.001% to 0.002% of the population (1). These tumors are usually positive for CD117 (c-KIT), which is the specific defining immunohistochemical feature indicating c-kit proto-oncogene mutations for these groups of tumors (2).…”

Extra-gastrointestinal stromal tumor presenting as a surgical emergency

“…There are rare cases of EGIST localization in the posterior mediastinum, liver, gallbladder, pancreas, urinary bladder, inguinal hernia sac, scrotum, uterus, fallopian tube, and rectovaginal septum, and another report of recurrent vaginal EGIST (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). These tumors could represent apparent GISTs that have arisen from the outermost muscle coat of the bowel, but have lost their contact to the point of origin due to an extensive extramural growth pattern (18).…”