Gastrointestinal stromal tumor in perforated Meckel’s diverticulum: a case report and literature review

Abstract

Introduction Gastrointestinal stromal tumor (GIST) is rare neoplasms of the gastrointestinal tract associated with high rates of malignant transformation. GIST has been found largely in the stomach, small bowel, colon and rectum, and esophagus, but about 5% are found in other locations. We herein report a 56-year-old woman with a GIST in perforated Meckel's diverticulum. After encountering this patient, a review of the literature found reports of 18 similar patients. Case presentation A 56-year-old woman diagnosed with galactosialidosis (β-galactosidase-neuraminidase deficiency) presented with vomiting. On contrast-enhanced computed tomography, peritonitis due to perforation of the intestine was diagnosed based on the free air and dilated loop of the small bowel. Laparotomy revealed perforation of Meckel’s diverticulitis located 50 cm from the ileocecal valve. Partial resection of the ileum, including the diverticulum, and end-to-end anastomosis of the small intestine were performed. Regarding the pathological findings, the edge of the diverticulum wall consisted of a solid mass measuring 1.0 cm in size, and the tumor cells were spindle-shaped with 1 mitosis present per 50 high-power fields. The diagnosis was established as GIST of the Meckel's diverticulum. The postoperative period was uneventful. Follow-up at two years revealed no evidence of recurrence. Conclusion GIST in perforated Meckel's diverticulum is very rare. The potential for the coexistence of GIST or other tumor should be considered in the treatment of perforated Meckel's diverticulum.

Gastrointestinal stromal tumor in ruptured Meckel's diverticulum located in jejunum caused myelosuppression for a short time: A case report

“…The association of GIST with MD is a known entity; it accounts for about 12% of the tumors associated with MD [ 20 ]. Recently, the literature has reported that GIST are the most common tumors responsible for perforation of a MD [ 21 ].The exact mechanism is unclear and may be related to tumor necrosis, making ulcer for the pressure of tumor, bowel obstruction and tumor invasion into the muscularis propria replacing the gut wall [ 22 ].…”

“…Tumors within MD are rare, with a reported incidence of 0.5% to 3.2%, these tumors are commonly benign, like leiomyomas, angiomas, and lipomas, and the majority of malignant neoplasms are adenocarcinoma, sarcoma, and carcinoid tumors, with few being GIST [ 7 ]. The location of GIST in MD is most common in ileum, rarely in jejunum [ 8 , 9 ] and myelosuppression caused by ruptured MD with a GIST has not been reported. We herein report a case of GIST in ruptured MD, and more importantly, the MD was located in the jejunum and the ruptured MD resulted in severe peritoneal cavity infection and myelosuppression within an hour.…”

Incidence and patterns of recurrence of prostate cancer on surveillance prostate biopsy following focal therapy with nanoknife

“…Gastrointestinal stromal tumour (GIST) arising in Meckel's diverticulum is rare. 1 We report a 23-year-old Samoan male who presented with a high grade GIST in his Meckel's diverticulum. The patient initially presented with acute appendicitislike symptoms.…”

Multinodular gastro intestinal stromal tumor in small intestine with perforation and Meckel’s diverticulitis- An unusual presentation

“…Patients may present with symptoms like-abdominal pain, abdominal mass, nausea, vomiting, anorexia, and weight loss. 6 There is no evidence for a preexisting diverticle, so a diverticulum is thought to be a secondary structure formed by the tumor. 5 Meckel's diverticulum is most common congenital abnormality seen in the gastrointestinal tract.…”