Duodenal Stromal Tumor: Report of a Case

Abstract

Gastrointestinal stromal tumors are rare tumors of the gastrointestinal (GI) tract that arise from primitive mesenchymal cells. Gastrointestinal stromal tumors account for approximately 80% all of gastrointestinal mesenchymal tumors. Duodenal stromal tumors (DSTs) manifest with unexplained melena, pain, bleeding, anemia, sometimes a partial duodenal obstruction and, rarely, with obstructive jaundice. If the tumor is successfully treated, its prognosis is usually good because of its non-aggressive nature. If resected, the prognosis is favorable in a majority of cases, and it is much better than in carcinomas of the duodenum. In this article, we report a case of DST originating from the first and second portion of the duodenum. Our patient did not have any problems postoperatively and remained symptom-free at 18 months after surgery.

Experience in clinical diagnosis and treatment of duodenal tumors

“…The incidence of GIST is ~1–2 per 200,000, and it may occur across the length of the entire digestive tract, from the esophagus to the anus, also including the retina, the mesentery, the peritoneum and the retroperitoneal area. Most commonly however, it occurs in the stomach and the small intestine, while duodenal stromal tumors are less frequent, accounting for only 10% of the small intestine (15). Duodenal stromal tumors are predominantly concentrated in the descending and horizontal portion of the duodenum, and less so in the bulb and the ascending portion (16).…”

Tumores Del Estroma Gastrointestinal (Gist) Del Duodeno: Presentación Clínica, Estudio Diagnóstico Y Tratamiento Actual

“…Los tumores de la primera porción duodenal localizados hacia la pared medial que se encuentran en contacto íntimo con la cabeza del páncreas deben ser tratados mediante pancreatoduodenectomía 16,19,20,25,26,42,43,45 . Los GIST localizados en la pared lateral cuando son menores a 3 cm (Figura 1), pueden ser tratados mediante resección local en cuña y sutura primaria o resección segmentaria 17,26,42,43,45,47 (Figura 3).…”

“…Cuando la resección en cuña deja un defecto Tabla 4. Procedimientos quirúrgicos recomendados de acuerdo a la localización del GIST en el duodeno [15][16][17][18][19][20][21]24,25,38,[42][43][44][45][46][47][48][49][50][51][52][53][54] Figura 5. A. Vista coronal que muestra un GIST en la pared lateral de la tercera porción del duodeno que medía 3 cm de diámetro, en una paciente de 61 años de edad.…”

Massive gastrointestinal bleeding caused by a gastrointestinal stromal tumour of the third part of the duodenum treated by means of emergency partial duodenal resection

“…The GIST grow intramurally: usually in the muscular, subserous, and submucosal layers, surrounded by a pseudocapsule, reaching a size of 1 to 30 cm. Tumours usually grow towards the peritoneal cavity; hence, the delayed symptoms when the tumour reaches a larger size (pain, intestinal obstruction) [ 9 ]. Tumour growth may be exophytic or endophytic, as it was in our case.…”

“…Usually in the case of GIST the pancreatic and biliary ducts are narrow, thus, the risk of postoperative fistula development is greater [ 7 ]. Small and medium-sized duodenal tumours, those unrelated to Vater's papilla, might be subjected to wedge resections [ 2 , 9 ] or segmental duodenectomy [ 6 , 11 ]. In the latter case the type of reconstruction will depend on the location of the tumour.…”