A case of a stomach gastrointestinal stromal tumor with extremely predominant cystic formation

Abstract

A 79-year-old male was referred to the hospital with a history of abdominal discomfort. Abdominal computed tomography revealed a cystic tumor with irregular wall thickness, approximately 50 mm in diameter, along the lesser curvature of the gastric body. Magnetic resonance imaging visualized the mass as signal-hyperintense on T2-weighted imaging. Esophagogastroduodenoscopy showed a submucosal tumor with normal mucosa. Surgery was performed and the 60 × 50 × 50 mm mass was resected. The resected tumor comprised cystic and solid regions; the cystic region was filled by light bloody serous fluid. On histological examination, a solid region of the resected tumor showed a spindle-cell appearance. The diagnosis was gastric gastrointestinal stromal tumor (GIST) with predominant cystic formation. GISTs are usually solitary tumors, but in this case the tumor demonstrated extremely predominant cystic formation. Lesions with a hemorrhage or necrosis may form large cystic spaces. GISTs may show extensive cystic changes in response to tyrosine kinase inhibitor treatment; however, this patient had not undergone any such treatment before diagnosis. This represents an interesting case of a gastric GIST with predominant cystic formation occupying most of the tumor volume. Care should be taken to differentiate between GISTs and actual intra-abdominal cystic lesions.

Gastrointestinal stromal tumors (GISTs) with remarkable cystic change: a specific subtype of GISTs with relatively indolent behaviors and favorable prognoses

“…Small cystic areas are frequently observed in GISTs with large size, but GISTs rarely manifest predominantly as cystic tumors. Cases of this uncommon form have been described but no retrospective study has been reported in the English literature (Hamza et al 2016 ; Okano et al 2015 ; Shaikh et al 2015 ; Sun et al 2016 ; Takahashi et al 2010 ; Wang et al 2017 ; Zhu et al 2014 ). In addition, clinical follow-up information was not available in most cases.…”

“…GISTs are typically solid, sometimes with small cystic area developed, but rarely manifest as predominant cystic neoplasms. To date, reports of this uncommon form of GISTs have comprised mostly case reports focusing mainly on its clinical and radiographic features (Hamza et al 2016 ; Okano et al 2015 ; Shaikh et al 2015 ; Sun et al 2016 ; Takahashi et al 2010 ; Wang et al 2017 ; Zhu et al 2014 ). There is very limited information in the literature relating to the pathologic features and prognoses of GISTs undergoing extensive cystic change.…”

Giant gastrointestinal stromal tumor with predominantly cystic changes: a case report and literature review

“…GISTs are typically large tumors, with diameters greater than 10 cm. Okano et al reviewed six reported cases of GIST with cystic changes, and the size of these tumors varied from 6 to 32 cm [ 2 ]. We further reviewed the English and Chinese literature and summarize the reported cases in Table 1 [ 4 , 6 – 13 ].…”

“…Although GISTs only occur in less than 5% of all gastrointestinal tract tumors, they account for 60% of all gastric stromal tumors [ 1 ]. GISTs are typically solid tumors and rarely present with predominantly cystic changes [ 2 ]. Here, we describe a case of giant GIST of the stomach with predominantly cystic changes that was cured with complete surgical resection without regional lymphadenectomy.…”

Gastric plexiform fibromyxoma resected by endoscopic submucosal dissection after observation of chronological changes: A case report

“…Although GIST typically appears as a solid mass, few studies have described myxoid GIST that also shows a plexiform growth pattern[10], and some cases of GIST have shown cystic changes as a result of degeneration or necrosis[11-13]. Thus, it may be difficult to distinguish PF from these GIST by performing EUS only once.…”