Hypovolemic Shock Revealing a Gastrointestinal Stromal Tumor

Abstract

Gastrointestinal stromal tumors (GISTs) are rare neoplasms that originate in the gastrointestinal tract. Due to the nonspecific symptoms, they are often underdiagnosed. Patients typically present with abdominal pain, weight loss, asthenia, or a sensation of a "ball in the stomach." Hypovolemic shock is a rare mode of presentation. The biopsy is often inconclusive, and immunohistochemistry plays a crucial role in diagnosis. Surgery is the treatment of choice for stromal tumors with hemorrhage.Here, we present two cases of patients admitted in critical condition with hypovolemic shock. Laboratory results revealed profound anemia. Upper gastrointestinal exploration demonstrated a tumor in both cases, with normal biopsy findings in one case. However, after partial gastrectomy, pathology results revealed GIST with an immunohistochemistry profile in favor. The mode of presentation in our cases is notable, as hypovolemic shock without apparent external bleeding is an unusual presentation. Therefore, physicians should consider GIST a possible diagnosis when presented with a patient in hypovolemic shock, even without externalized bleeding.