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A gastrointestinal stromal tumor with mesenteric and retroperitoneal invasion.

Engin G, Asoglu O, Kapran Y, Mert G - World J Surg Oncol (2007)

Bottom Line: Ultrasonography-guided true-cut biopsy was made, histopathologic and immunohistochemical analyses demonstrated stromal tumor which, C-KIT (+).Postoperative histopathological analyses revealed lower grade malignant GISTs.As of 17 months after the surgery, he is alive and free of recurrence.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Radiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey. gengin@istanbul.edu.tr

ABSTRACT

Background: Gastrointestinal stromal tumors are rare visceral sarcomas arising in the gastrointestinal tract wall. In this report we present a case of gastrointestinal stromal tumors with mesenteric and retroperitoneal invasion, describe and discuss its computed tomography findings.

Case presentation: A 57-years-old male patient has been complaining of abdominal distention, weight lose, and hematuria. During physical examination, significant distention and multiple palpable tumor masses were identified on the abdomen. Abdominal computed tomography showed multiple, well-defined, soft tissue masses with homogenous and heterogeneous pattern, in the mesenteric and retroperitoneal areas. Unlike specific features of gastrointestinal stromal tumor, renal obstruction and atypical central calcification without chemotherapy that has not been yet described were seen in this case. Computed tomography did not reveal liver metastases and/or the lymph nodes with pathological size. Ultrasonography-guided true-cut biopsy was made, histopathologic and immunohistochemical analyses demonstrated stromal tumor which, C-KIT (+). The patient underwent left ureterectomy, left nephrectomy and total colectomy. Postoperative histopathological analyses revealed lower grade malignant GISTs. As of 17 months after the surgery, he is alive and free of recurrence.

Conclusion: When intraabdominal, multiple, large (>5 cm), well-circumscribed, homogenous or heterogeneous mass lesions without ascites, omental caking and lymph nodes metastases were seen, gastrointestinal stromal tumors should be considered in the differential diagnosis.

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Abdominal CT image of slightly more distal of figure 3 shows multiple, homogenous or central necrotic (black arrows) or calcific (white arrow) masses invaded to the small bowel mesentery and left ureter (arrowhead).
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Figure 4: Abdominal CT image of slightly more distal of figure 3 shows multiple, homogenous or central necrotic (black arrows) or calcific (white arrow) masses invaded to the small bowel mesentery and left ureter (arrowhead).

Mentions: A 57-years-old male patient was admitted to the general surgery department with abdominal distention, weight loss and hematuria. During physical examination, significant distention and multiple palpable tumor masses were identified on the abdomen (Figure 1). Contrast-enhanced abdominal multi detector CT imaging was performed with a four-detector row CT scanner (Somatom Sensation 4®, Siemens Medical Solutions, Erlangen, Germany). Multiple, well-defined, soft tissue masses with homogenous pattern, measuring maximum 6 × 5 cm in size were observed in the mesenteric and retroperitoneal areas (Figure 2, 3). In some masses, central necrosis and coarse calcifications were seen (Figure 4). There was grade 3 hydronephrosis in the left kidney due to the left ureteric invasion (Figure 2, 3, &4). However, CT did not reveal liver metastasis and/or the lymph nodes with pathological size.


A gastrointestinal stromal tumor with mesenteric and retroperitoneal invasion.

Engin G, Asoglu O, Kapran Y, Mert G - World J Surg Oncol (2007)

Abdominal CT image of slightly more distal of figure 3 shows multiple, homogenous or central necrotic (black arrows) or calcific (white arrow) masses invaded to the small bowel mesentery and left ureter (arrowhead).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2164961&req=5

Figure 4: Abdominal CT image of slightly more distal of figure 3 shows multiple, homogenous or central necrotic (black arrows) or calcific (white arrow) masses invaded to the small bowel mesentery and left ureter (arrowhead).
Mentions: A 57-years-old male patient was admitted to the general surgery department with abdominal distention, weight loss and hematuria. During physical examination, significant distention and multiple palpable tumor masses were identified on the abdomen (Figure 1). Contrast-enhanced abdominal multi detector CT imaging was performed with a four-detector row CT scanner (Somatom Sensation 4®, Siemens Medical Solutions, Erlangen, Germany). Multiple, well-defined, soft tissue masses with homogenous pattern, measuring maximum 6 × 5 cm in size were observed in the mesenteric and retroperitoneal areas (Figure 2, 3). In some masses, central necrosis and coarse calcifications were seen (Figure 4). There was grade 3 hydronephrosis in the left kidney due to the left ureteric invasion (Figure 2, 3, &4). However, CT did not reveal liver metastasis and/or the lymph nodes with pathological size.

Bottom Line: Ultrasonography-guided true-cut biopsy was made, histopathologic and immunohistochemical analyses demonstrated stromal tumor which, C-KIT (+).Postoperative histopathological analyses revealed lower grade malignant GISTs.As of 17 months after the surgery, he is alive and free of recurrence.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Radiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey. gengin@istanbul.edu.tr

ABSTRACT

Background: Gastrointestinal stromal tumors are rare visceral sarcomas arising in the gastrointestinal tract wall. In this report we present a case of gastrointestinal stromal tumors with mesenteric and retroperitoneal invasion, describe and discuss its computed tomography findings.

Case presentation: A 57-years-old male patient has been complaining of abdominal distention, weight lose, and hematuria. During physical examination, significant distention and multiple palpable tumor masses were identified on the abdomen. Abdominal computed tomography showed multiple, well-defined, soft tissue masses with homogenous and heterogeneous pattern, in the mesenteric and retroperitoneal areas. Unlike specific features of gastrointestinal stromal tumor, renal obstruction and atypical central calcification without chemotherapy that has not been yet described were seen in this case. Computed tomography did not reveal liver metastases and/or the lymph nodes with pathological size. Ultrasonography-guided true-cut biopsy was made, histopathologic and immunohistochemical analyses demonstrated stromal tumor which, C-KIT (+). The patient underwent left ureterectomy, left nephrectomy and total colectomy. Postoperative histopathological analyses revealed lower grade malignant GISTs. As of 17 months after the surgery, he is alive and free of recurrence.

Conclusion: When intraabdominal, multiple, large (>5 cm), well-circumscribed, homogenous or heterogeneous mass lesions without ascites, omental caking and lymph nodes metastases were seen, gastrointestinal stromal tumors should be considered in the differential diagnosis.

Show MeSH
Related in: MedlinePlus