Spontaneous intratumoral bleeding and rupture of giant gastric stromal tumor (&gt; 30 cm) in a young patient

Cruz, Ruy J.; Vincenzi, Rodrigo; Ketzer, Bernardo Mazzini; Cecilio, Andre L; Cepeda, Lourdes Alves

doi:10.1186/1477-7819-6-76

Cited by 32 publications

(20 citation statements)

References 14 publications

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“…[10][11][12][13][14][15][16][17][18][19][20][21] In all cases, the tumor size was >5 cm, 12 of the 15 patients were older than 60 years, and the male-tofemale ratio was 2 : 1. Seven GISTs arose from the stomach 10,11,13,15,19,21 and four from the small intestine. [12][13][14]20 One case each originated from the mesocolon, 16 esophagus, 17 and greater omentum.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous rupture of a sigmoid colon gastrointestinal stromal tumor manifesting as pneumoretroperitoneum with localized peritonitis: Report of a case

et al. 2011

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Colonic gastrointestinal stromal tumors (GISTs) account for only 5%-10% of tumors arising in the digestive tract. Spontaneous rupture is a very rare manifestation of a GIST; however, we report what to our knowledge is the first documented case of pneumoretroperitoneum caused by the rupture of a GIST. A 77-year-old woman was admitted to our hospital with acute abdominal pain and hematochezia. Colonoscopy showed luminal narrowing in the sigmoid colon, but no definite mucosal defect. Computed tomography (CT) showed an air-containing heterogeneous mass, 9.7 × 9.3 cm, in the pelvic cavity and a small amount of air in the retroperitoneum. Emergency laparotomy revealed a ruptured sigmoid colonic GIST with localized peritonitis. Pathologic examination confirmed that the tumor was composed mainly of round epithelioid cells. It was immunohistochemically positive for CD34 and negative for C-kit protein. This report describes how we successfully managed pneumoretroperitoneum with localized peritonitis caused by the spontaneous rupture of an epithelioid GIST originating from the sigmoid colon.

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Section: Discussionmentioning

confidence: 99%

Spontaneous rupture of a sigmoid colon gastrointestinal stromal tumor manifesting as pneumoretroperitoneum with localized peritonitis: Report of a case

et al. 2011

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“…Firstly, these tumors exhibit a GIST-typical localization between either the circular and longitudinal muscle layer or the longitudinal muscle layer and the serosa of the gut wall. Secondly, although blood-filled cysts are rare in human GIST 38 , the histology and molecular features of these tumors resemble GIST rather than other tumors of the gut, including LMS, the most important differential diagnosis of GIST. Thirdly, they are responsive to the GIST drug imatinib.…”

Section: Discussionmentioning

confidence: 99%

Inactivation of Patched1 in Mice Leads to Development of Gastrointestinal Stromal-Like Tumors That Express Pdgfrα but Not Kit

et al. 2013

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Background and aims A fraction of gastrointestinal stromal tumors (GIST) overexpress PDGFRA rather than KIT. Presently it is unknown if this reflects a complementary oncogenic potential of PDGFRA and KIT pathways, or heterogeneity in the cellular origin of GIST. Similarly unknown is the significance of activated Hedgehog (HH)/PATCHED1 (PTCH) signaling found in many GIST. Methods Mouse Ptch was conditionally inactivated using a Cre recombinase driven by the lysozyme M (LysM) promoter. Lineage tracing was done using R26R-LacZ reporter mice. Tumors were characterized by in situ hybridization, immunohistochemistry, Western blot and qRT-PCR. Cellular transformation was assessed by clonogenic assay. Results Inactivation of Ptch in LysM-expressing cells resulted in imatinib-responsive tumors of GIST-like localization and histology. In addition to activation of Hh signaling, the tumors showed overexpression and activation of Pdgfrα, but not of Kit. Lineage tracing revealed that LysM-expressing intestinal cells were Kit-negative. These cells were juxtapposed with Kit-positive interstitial cells of Cajal (ICC) and sometimes co-expressed Pdgfrα. In contrast to KIT, PDGFRA cooperated with HH signaling in cellular transformation. Conclusions Mutations in Ptch result in formation of Pdgfrα-positive Kit-negative GIST-like tumors in mice. These tumors may develop due to cooperativity between Hh and Pdgfrα pathways from Kit-negative cells in the intestine.

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“…This is rare but has been reported before in GISTs of the stomach,2 ileum3 or ileal mesentery 4. An acute surgical abdomen can also be caused by acute intratumoural bleeding without haemoperitoneum5 or sudden tumour perforation 3 6. Presenting symptoms in the elective situation may include nausea, vomiting, anorexia, weight loss and abdominal pain.…”

Section: Discussionmentioning

confidence: 89%

Traumatic rupture of a gastrointestinal stromal tumour with intraperitoneal bleeding and haematoma formation

Mohamed

Griffiths²,

Witkowski³

et al. 2010

Case Reports

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SummaryA 40-year-old man presented with acute abdominal pain and falling haemoglobin after a history of minor abdominal trauma. Radiological imaging showed a large soft tissue mass situated between the anterior stomach wall and peritoneum. At diagnostic laparoscopy, intra-abdominal blood and an encapsulated haematoma were found. The procedure was converted to midline laparotomy and the mass was excised, including a stalk of tissue that connected the mass to the anterior prepyloric stomach wall. The patient recovered well and was discharged after 9 days. Histology confirmed a gastrointestinal stromal tumour surrounded by haematoma formation. BACKGROUND

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Spontaneous intratumoral bleeding and rupture of giant gastric stromal tumor (> 30 cm) in a young patient

Abstract: Background: Few cases of GIST bigger than 15 cm have been reported in medical literature, all primarily in elderly patients. We report an unusual case, in which a giant gastric GIST -in a young patient -presented as spontaneous intratumoral bleeding followed by intraluminal rupture.

Cited by 32 publications

References 14 publications

Spontaneous rupture of a sigmoid colon gastrointestinal stromal tumor manifesting as pneumoretroperitoneum with localized peritonitis: Report of a case

Spontaneous rupture of a sigmoid colon gastrointestinal stromal tumor manifesting as pneumoretroperitoneum with localized peritonitis: Report of a case

Inactivation of Patched1 in Mice Leads to Development of Gastrointestinal Stromal-Like Tumors That Express Pdgfrα but Not Kit

Traumatic rupture of a gastrointestinal stromal tumour with intraperitoneal bleeding and haematoma formation

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