A Predominant Pelvic Gastrointestinal Stromal Tumor (GIST) Mass Observed on Tc-99m Red Blood Cell Gastrointestinal Bleeding Scintigraphy

Abstract

A 51-year-old woman presented with recurrent bleeding per rectum. Her earlier endoscopies were negative. Tc-99m RBC GI bleeding scintigraphy was performed. It demonstrated an apparent hypervascular pelvic mass, and active small bowel bleeding. Based on scintigraphic finding of a predominant pelvic mass indicating tumor, CT of the abdomen and pelvis was performed for further gastrointestinal bleeding localization work up instead of an invasive angiography or endoscopy, which detected a small bowel tumor in the pelvis. A small bowel gastrointestinal stromal tumor was resected subsequently.

The SNMMI Procedure Standard/EANM Practice Guideline for Gastrointestinal Bleeding Scintigraphy 2.0

“…Nonenteric bleeding activity can move and accumulate and confuse interpretation, including intraperitoneal hemorrhage (108,109), mesenteric bleeding (110), and soft-tissue hematoma/hemorrhage (111)(112)(113)(114)(115)(116). Both benign and malignant neoplasms and metastatic disease can cause hyperemia and bleeding when ulcerated or necrotic (117)(118)(119)(120)(121)(122)(123)(124)(125)(126). Retroperitoneal bleeding can show focal uptake that grows in intensity but is not expected to move in a luminal pattern (127).…”