ASSYMTPOMATIC GIANT GASTROINTESTINAL STROMAL TUMOR (GIST): CLINICAL CASE REPORT
DOI:
https://doi.org/10.34635/rpc.686Keywords:
Giant GIST, diagnosis, surgical treatment, prognosisAbstract
GISTs are rare mesenchymal tumors, which may present as millimetric lesions or bulky masses. They are usually clinically silent until they reach a significant size, so their finding is often incidental. We report the case of a 92 – year – old female patient admitted to the Emergency Department due to clinical symptoms of right hypochondrium (RH) pain, nausea and vomiting, developing within a few hours. Clinical examination revealed tenderness in the RH and a palpable painless mass in the epigastric/left upper quadrants, of 10 x 10 cm. Blood tests and ultrasonography confirmed the diagnostic hypothesis of choledocholithiasis and also revealed a solid, heterogeneous mass of 14 x 8 x 9 cm, with cystic areas and cleavage planes. Endoscopic retrograde cholangiopancreatography (ERCP) was performed with endoscopic sphincterotomy (EST) and removal of calculi with no complications. The patient had open surgery so as to approach the gallblader and the mass at the same surgical time. Gastric wedge resection and cholecystectomy were performed. The histological and immunohistochemical analysis of the lesion showed a high-risk GIST. Due to the advanced age of the patient and the existing co-morbidities, it was decided not to perform adjuvant therapy with imatinib, as usually indicated. Review of literature show that giant GISTs of the stomach are rare and usually symptomatic. Complete surgical resection is the standard treatment in locally resectable GISTs, with adjuvant therapy being indicated for high-risk tumors.
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