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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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In microscopic appearance of immunohistochemical analyses, CD117   immunoreactivity is shown as diffuse strong cytoplasmic staining in spindle   cell (CD117 immunostain, W200).
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Figure 7: In microscopic appearance of immunohistochemical analyses, CD117 immunoreactivity is shown as diffuse strong cytoplasmic staining in spindle cell (CD117 immunostain, W200).

Mentions: Ultrasonography (US)-guided true-cut® biopsy was made, histopathologic (Figure 5, 6) and immunohistochemical analyses demonstrated stromal tumor which, C-KIT (+)(Figure 7), CD34 (-), S-100 (-), desmin (-), actine (-) Ki-67 (+)(Figure 8) and with a proliferation index of <%1. During the operation, not only the tumor filling the whole abdomen but masses invading small bowel mesentery, left hemicolon and the left ureter have been detected. The patient underwent left ureterectomy, left nephrectomy and total colectomy. Proximally from the treitz, small bowel resection from a distance of 200 cm was applied. The mass have been totally removed and taken out of the abdomen (Figure 9). The operation has been completed with an end-ileostomy (Figure 10).


A gastrointestinal stromal tumor with mesenteric and retroperitoneal invasion.

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

In microscopic appearance of immunohistochemical analyses, CD117   immunoreactivity is shown as diffuse strong cytoplasmic staining in spindle   cell (CD117 immunostain, W200).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 7: In microscopic appearance of immunohistochemical analyses, CD117 immunoreactivity is shown as diffuse strong cytoplasmic staining in spindle cell (CD117 immunostain, W200).
Mentions: Ultrasonography (US)-guided true-cut® biopsy was made, histopathologic (Figure 5, 6) and immunohistochemical analyses demonstrated stromal tumor which, C-KIT (+)(Figure 7), CD34 (-), S-100 (-), desmin (-), actine (-) Ki-67 (+)(Figure 8) and with a proliferation index of <%1. During the operation, not only the tumor filling the whole abdomen but masses invading small bowel mesentery, left hemicolon and the left ureter have been detected. The patient underwent left ureterectomy, left nephrectomy and total colectomy. Proximally from the treitz, small bowel resection from a distance of 200 cm was applied. The mass have been totally removed and taken out of the abdomen (Figure 9). The operation has been completed with an end-ileostomy (Figure 10).

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