Giant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort: a case report

Fujisawa, Ryosuke; Akiyama, Yuji; Iwaya, Takeshi; Endo, Fumitaka; Nikai, Haruka; Baba, Shigeaki; Chiba, Tadatoshi; Kimura, Toshimoto; Takahara, Taro; Otsuka, Koki; Nitta, Hiroyuki; Morita, Masaru; Koeda, Keisuke; Sasaki, Akira

doi:10.1186/s40792-018-0553-x

Cited by 3 publications

(3 citation statements)

References 19 publications

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“…It is unclear why colon cancer in Morgagni hernias is much more common than in other diaphragmatic hernias. We have not found a single case of colon cancer associated with a type 4 hiatal hernia; however, large paraesophageal hernias have been found to contain gastric cancer [18] and other tumors such as gastrointestinal stromal tumors [19], with Wolfe et al reporting ovarian cancer metastases causing a symptomatic paraesophageal hernia [20]. One explanation for the differences seems to be the much higher incidence of ascending colon compared to descending colon cancer.…”

Section: Discussionmentioning

confidence: 67%

Laparoscopic Repair of Morgagni Hernia Combined with Right Hemicolectomy for Bleeding Ascending Colon Carcinoma Lodged within the Chest: A Case Report and Review of the Literature

Onafowokan¹,

Khosa²,

Bonatti³

2021

Case Reports in Surgery

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Background. Morgagni hernias are rare in adults and may be asymptomatic but, nevertheless, require surgical repair, with laparoscopy offering an excellent option. The colon dislodged into the chest through diaphragmatic hernias may be affected by various disorders, including malignancies. Case Report. A 70-year-old obese male presented with fatigue and shortness of breath. CT scan showed the right colon lodged in the chest through a Morgagni hernia. He was anaemic, and colonoscopy revealed a colon cancer. He underwent combined laparoscopic hernia repair with bioabsorbable mesh and right hemicolectomy. Recovery was uneventful, but the patient died 5 months later from chemotherapy-associated cardiac failure. Literature review revealed eight similar published cases, and including ours, there were seven Morgagni hernias, one traumatic hernia, and one Bochdalek hernia. Median age of the five men and four women was 66 (range 49-85) years. Surgical approach was thoracotomy (2), laparotomy (5), and laparoscopy (2). Conclusion. Outcome of the rare condition is determined by the course of the colon cancer. Hernia repair was successful in ours and all other published cases. A combined laparoscopic approach can be safely done.

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Section: Discussionmentioning

confidence: 67%

Laparoscopic Repair of Morgagni Hernia Combined with Right Hemicolectomy for Bleeding Ascending Colon Carcinoma Lodged within the Chest: A Case Report and Review of the Literature

Onafowokan¹,

Khosa²,

Bonatti³

2021

Case Reports in Surgery

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“…ere have been several studies showing that the coexistence between hiatal hernia and lower esophageal submucosal tumor was very common [1,7,12,13]. A case series on 66 patients who underwent surgery therapy for esophageal leiomyoma found that hiatal hernia presented in 15 (23%) patients [13].…”

Section: Discussionmentioning

confidence: 99%

Missed Giant Lower Esophageal Leiomyoma in a Young Female Presenting with Refractory Gastroesophageal Reflux Disease

Quach

Luu

2021

Case Reports in Medicine

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Esophageal leiomyoma is a rare disease commonly reported in middle-aged patients with a male predominance. Many patients are asymptomatic, and a few may present with symptoms such as dysphagia and chest pain. However, heartburn is only reported in patients with accompanying hiatal hernia. We hereby report a giant lower esophageal leiomyoma with concomitant hiatal hernia in a young Vietnamese female, who presented with refractory gastroesophageal reflux symptoms. The diagnosis was challenging as the tumor grew outward. As a consequence, the patient did not experience dysphagia and the tumor was hardly detected under endoscopy. The hiatal hernia in this patient was probably related to the presence of the leiomyoma. It is important to look carefully for submucosal tumor at the lower esophagus and cardia under endoscopy in patients with similar manifestations.

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“…GISTs are 4 times more likely to recur if the primary site is the intestine compared to stomach. These data should be considered when evaluating success of surgical resection of recurrent tumors since the primary site could potentially condition the ultimate outcome in form of overall survival and recurrence-free survival [10][11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Urgent Surgical Treatment of GIST of Esophago-Gastric Junction in a Patient with Giant Hiatal Hernia

Romić¹,

Pavlek²,

Romic³

et al. 2019

Klin Onkol

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Gastrointestinal stromal tumors (GISTs), being the most common mesenchymal tumors of the gastrointestinal tract, arise most commonly in stomach (60-70%) and small intestine (20-25%) while other sites of origin are rare. In most cases, they are dia gnosed accidentally due to their indolent clinical course; however, 10-30% have malignant potential. Gastric and esophageal GISTs carry a better prognosis than small bowel GISTs of similar size and mitotic rate. Complete surgical resection is the only potentially curative procedure, but despite its success, at least 50% of patients develop recurrence or metastases. Tyrosine kinase inhibitor imatinib gave positive results in treatment of unresectable, metastatic or recurrent GISTs. We present the case of a 69-year-old woman with a large unresectable GIST of esophago-gastric junction with multiple bilobar liver metastases who underwent an emergent palliative surgery due to diffuse bleeding from the tumor. Twelve months after the surgery, patient is still alive and stable under imatinib therapy with no signs of local recurrence of the disease. This example suggests that patients with locally advanced GISTs with distant metastases may benefit from surgery in terms of prolonged survival and quality of life. SouhrnGastrointestinální stromální tumory (GIST), které jsou nejčastějšími mezenchymálními nádory gastrointestinálního traktu, se nejčastěji vyskytují v žaludku (60-70 %) a tenkém střevě (20-25 %), zatímco jiná místa původu jsou vzácná. Z důvodu indolentního klinického průběhu jsou ve většině případů dia gnostikovány náhodně, 10-30 % však vyjadřuje maligní potenciál. GIST žaludku a jícnu mívají lepší prognózu než GIST tenkého střeva podobné velikosti a rychlosti mitózy. Úplná chirurgická resekce je jediným potenciálně léčebným zákrokem, ale navzdory jejímu úspěchu se u nejméně 50 % pacientů objeví recidiva nebo metastázy. Pozitivní výsledky v léčbě neresekovatelných, metastatických nebo rekurentních GIST vykazoval inhibitor tyrozinkinázy imatinib. Prezentujeme případ 69leté ženy s velkým neresekovatelným GIST ezofágo-gastrického spojení s mnohočetnými metastázami jaterních bilobarů, která podstoupila paliativní chirurgickou operaci v důsledku difuzního krvácení z nádoru. Dvanáct měsíců po operaci je pacientka stále naživu a stabilní při léčbě imatinibem bez známek lokální recidivy onemocnění. Tento příklad naznačuje, že pacienti s lokálně pokročilými GIST se vzdálenými metastázami mohou mít prospěch z operace z hlediska prodlouženého přežití a kvality života. Klíčová slova GIST -žaludek -hiátová hernie -resekceThe authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.Autoři deklarují, že v souvislosti s předmětem studie nemají žádné komerční zájmy.The Editorial Board declares that the manuscript met the ICMJE recommendation for biomedical papers.Redakční rada potvrzuje, že rukopis práce splnil ICMJE kritéria pro publikace zasílané do bi omedicínských časopisů.

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Giant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort: a case report

Cited by 3 publications

References 19 publications

Laparoscopic Repair of Morgagni Hernia Combined with Right Hemicolectomy for Bleeding Ascending Colon Carcinoma Lodged within the Chest: A Case Report and Review of the Literature

Laparoscopic Repair of Morgagni Hernia Combined with Right Hemicolectomy for Bleeding Ascending Colon Carcinoma Lodged within the Chest: A Case Report and Review of the Literature

Missed Giant Lower Esophageal Leiomyoma in a Young Female Presenting with Refractory Gastroesophageal Reflux Disease

Urgent Surgical Treatment of GIST of Esophago-Gastric Junction in a Patient with Giant Hiatal Hernia

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