Abstract
Introduction: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors that can arise anywhere within the gastrointestinal tract. Approximately 70 % are in the Stomach, representing 1 – 3 % of all gastrointestinal malign neoplasms. GISTs originate from the Cajal interstitial cells or their stem cell precursors within the myenteric plexus of the muscularis propria.
Histologically, GIST presents three different architectural patterns: a. composed of epitheloid cells embedded in a thin reticular stroma; b. by spindle cells with a fascicular or storiform arrangement immersed in a thin reticular stroma focally myxoid, and c. the mixed forme.
This study describes a 72-year-old man who, in the computed tomography, presented a gross appearance as pancreatic cystic neoplasia. Clinicians should be aware that this condition might be mistaken for a primary pancreatic malignancy.
The diagnostic Workup includes endoscopy with ultrasonography, cross-sectional imaging studies, and histopathological examination.
Conclusions: The reported case illustrates that the retroperitoneum might be the place of initial presentation of a cystic gastric GIST and that only an accurate pathological evaluation can establish the diagnosis and origin. Clinicians must know this condition might be mistaken for a primary pancreatic malignancy. Early surgical resection is the gold standard of treatment for primary GIST.
References
2. Lutfi Alia. (2020). Pathological basis of diseases. Volume 2. Nonepithelial neoplasms of gastrointestinal stromal tumor. Publications "Streha" Page 413 - 415. Tirana, Albania
3. Casali PG, Blay JY, Abecassis N, Bajpai J, Bauer S, Biagini R et al. (2022) Gastrointestinal Stromal Tumors: ESMO-EURACAN_Genturis Clinical Practice Guidelines for diagnosis, treatment, and follow-up. Annals Oncol. Jan: 33 (1): 20 – 33
4. Versaci A, Macrì A, Ieni A, Terranova M, Leonello G, Saldino E et al; (2009) Gastrointestinal Stromal tumor: our experience. Chirurgia Italiana. 61: 161 – 169
5. Ballati A, Essaidi Z, et al. (2021). A gastrointestinal stromal tumor of the Stomach presents with an Intratumoral abscess: A case report. Annal. Med. Surgery (London). 2021, February 2; 63: 102 -143
6. Waidhauser J., Bornemann A., Trepel M., Märkl B. (2019). Frequency, localization, and types of Gastrointestinal stromal tumor-associated neoplasia. World Journal. Gastroent. 25: 4261–4277.
7. Cao H, Zhang Y, Wang M, et al. (2010). Prognostic analysis of patients with Gastrointestinal Stromal Tumors: a single unit experience with surgical treatment of primary disease. Chinese Medical Journal. Jan. 20; 123 (2): 131 - 136
8. Lahmar-Boufaroua A, Ben Slama S, Borraoui S, et al. (2009). Review of 32 gastrointestinal Stromal tumors with CD117 antigen. Tunis Medic. Feb; 87 (2): 133 - 136
9. Sharma A. K et al. (2021) Location of Gastrointestinal Stromal Tumor (GIST) in the Stomach
10. Predicts Tumor Mutation Profile and Drug Sensitivity. Clinic. Cancer Research. October 1; 27 - 31
11. Roggin K.K, Posner MC. (2012). Modern treatment of gastric gastrointestinal stromal tumors. World Journal. Gastroenterol. Dec. 14; 18 (46); 6720 – 6728
12. Miettinen M, Wang Z. F, Lasota J. (2009). DOG1 antibody in the differential diagnosis of Gastrointestinal tumors: a study of 1840 cases. Am. Journ. Surg. Pathology. sept.33 (9), 1401-8
13. Akahoshi K, Oya M, Koga T, Shiratsuchi Y. (2018). Current clinical management of GastroIntestinal Stromal Tumor. World Journal. Gastroenterol. Jul. 14; 24 (26); 2806 – 2817
14. Samaras VD, Foukas PG, Triantafyllou K, et al. (2011). Synchronous well-differentiated neuroendocrine and gastrointestinal stromal tumor of the Stomach: a case report. BMC Gastroenterology. March 24; 11 – 27.
15. 14.Sharma N. R, Gopakumar H, Harrison S, Ehmke Zelt. (2019) Gastric gastrointestinal Stromal Tumors (GIST): A case series and Current State of the Art in the Workup and treatment of this Rare disease. Journ. Gastrointest. Cancer. Sept. 50 (3): 548 – 555
16. Samardzic J, Hreckovski B, et al. (2015). Laparoscopic Wedge Resection of Gastric Stromal Tumor (GIST). Med. Archive. Jun; 69 (3): 203 – 205.
17. Rahmutulla B, Matsushita K, Nomura F., et al. (2014). Alternative splicing of DNA damage response genes and gastrointestinal cancers. World Journal of Gastroenterology. December 14; 20 (46): 17305 - 17313
18. Li Z, Zhou Y, Jiang Y, Liu Y. (2023). Giant gastric myxoid epitheloid gastrointestinal stromal Tumor. Dig Liver Disease, Feb; 55 (2); 296 -297
19. Carter BM, Bronsert MR, Wilky BA, McCarter MD. (2023). Mucosal ulceration in Gastrointestinal Stromal Tumors is an independent Progression – Survival Predictor. Journ Surg. Res. Apr; 284: 221 - 229
20. Burch J, Ahmad I. (2023). Gastrointestinal Stromal Cancer. September 26. In StatPearls, Treasure Island (FL). PMID: 32119428
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