Rectovaginal extragastrointestinal stromal tumour (EGIST): an additional entity to be considered in the differential diagnosis of tumours of the rectovaginal septum

Abstract

Gastrointestinal stromal tumours (GISTs) are rare - and rectovaginal extragastrointestinal stromal tumours (RV-EGISTs) even rarer. We share a case of RV-EGIST, complemented by high-quality radiological and surgical images. A review of current literature pertaining to RV-EGIST is also included. Our case report highlights the diagnostic challenge presented by extragastrointestinal stromal tumours. Differentiated from overlapping pathologies only by targeted application of immunohistopathology and cytogenetics, the inclusion of RV-EGIST in the differential diagnosis of a rectovaginal tumour is essential to making this correct diagnosis. Primary surgery is the treatment of choice for RV-EGIST if complete cytoreduction can be achieved, combined with adjuvant tyrosine kinase inhibitor (TKI) therapy for those with high-risk features to further reduce rates of future recurrence.

Radical Total Pelvic Exenteration with Concomitant Right Nephrectomy in the Management of Recurrent Endometrioid Ovarian Adenocarcinoma: A Case Report and Literature Review

“…Until new treatments options are identified, surgery with maximal cytoreductive effort remains the mainstay treatment for this histological subtype of ovarian cancer [17][18][19][20][21][22][23][24][25]. Achieving resection of all macroscopic disease (R0) is the single independent factor for survival.…”

Radical total pelvic exenteration with concomitant right nephrectomy in the management of recurrent endometrioid ovarian adenocarcinoma: A case report and literature review

“…Until new treatments options are identified, surgery with maximal cytoreductive effort remains the mainstay treatment for this histological subtype of ovarian cancer. 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 Achieving resection of all macroscopic disease (R0) is the single independent factor for survival. In their meta‐analysis including 6885 patients with advanced ovarian cancer, Bristow et al (2023) have shown there is a 5.5% increase in median survival time with each 10% increase in maximal cytoreduction.…”

“…Until new treatments options are identified, surgery with maximal cytoreductive effort remains the mainstay treatment for this histological subtype of ovarian cancer 18–26 . Achieving resection of all macroscopic disease (R0) is the single independent factor for survival.…”

Complex hidradenitis suppurativa on a background of long‐standing Crohn's disease requiring radical pelvic and perineal reconstruction: A case report

“…In line with this, it has been shown that surgical MDTs can decrease peri‐ 18 and postoperative 19 mortality. Due to the complexity of pelvic anatomy and the broad array of structures contained within it, MDT surgical collaboration has often been described for pelvic and other gynecological surgeries, resulting in successful patient outcomes 20–22 . Overall, this approach was effectively utilized to maximize the chance of eradication of disease from the perineum, minimizing recurrence risk which should have a significant and positive impact on the patient's quality of life.…”

“…Due to the complexity of pelvic anatomy and the broad array of structures contained within it, MDT surgical collaboration has often been described for pelvic and other gynecological surgeries, resulting in successful patient outcomes. [20][21][22] Overall, this approach was effectively utilized to maximize the chance of eradication of disease from the perineum, minimizing recurrence risk which should have a significant and positive impact on the patient's quality of life. Ongoing MDT input will be essential to continue to manage her hidradenitis suppurativa, with medical specialty involvement, such as dermatology, hopefully meaning that further surgical intervention is not necessitated.…”