Case Reports in Gastroenterology (Mar 2010)

Gastrointestinal Stromal Tumor of the Stomach with Narrow Stalk-Like Based, Uneven Protruding Appearance Presenting with Severe Acute Anemia despite Small Size

  • Tomomitsu Tahara,
  • Tomoyuki Shibata,
  • Masakatsu Nakamura,
  • Hiromi Yamashita,
  • Daisuke Yoshioka,
  • Masaaki Okubo,
  • Naoko Maruyama,
  • Toshiaki Kamano,
  • Yoshio Kamiya,
  • Yoshihito Nakagawa,
  • Hiroshi Fujita,
  • Mitsuo Nagasaka,
  • Masami Iwata,
  • Kazuya Takahama,
  • Makoto Watanabe,
  • Tomiyasu Arisawa,
  • Ichiro Hirata

DOI
https://doi.org/10.1159/000292433
Journal volume & issue
Vol. 4, no. 1
pp. 111 – 117

Abstract

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We report the case of a 56-year-old woman who had a gastrointestinal stromal tumor (GIST) of the stomach. She was admitted to our hospital for epigastric pain, nausea, and severe acute anemia (hemoglobin level 4.3 g/dl). Esophagogastroduodenoscopy revealed a narrow stalk-like based, hemorrhagic and uneven protruding lesion in the lesser curvature of the gastric upper corpus. Although the tumor was less than 2 cm in diameter and was probably a benign GIST according to histology, laparoscopy-assisted local resection was needed because the patient had continuous severe anemia and epigastric pain. Histological assessment showed that the elongated spindle-like tumor cells originated from the intrinsic muscle layer, and was shown with growth to the mucosal side, cropping out to the surface in most areas of the protruding lesion. Only a small part of the tumor was within nontumoral gastric mucosa. Most of the tumor cells demonstrated immunoreactivity for KIT and CD34 in the cytoplasm but not for αSMA, S100, and desmin. Mitotic activity (0/50 high power field) and the labeling index for MIB-1 (about 1%) were low. The GIST of the stomach described in this report was a rare case with a narrow stalk-like based, uneven protruding mass presenting with severe acute anemia despite small size.

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