Gastrointestinal stromal tumour of the jejunum in an elderly female patient with atypical symptomatology
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CASE REPORT
Gastrointestinal Stromal Tumour of the Jejunum in an Elderly Female Patient with Atypical Symptomatology Georgios Zacharis, Nada Zacharis, Charalampos Potsios, Panagiota Xaplanteri
Abstract Gastrointestinal stromal tumour (GIST) neoplasms are rare malignancies of the gastrointestinal tract. Most commonly they present with gastrointestinal bleeding and abdominal pain as the main symptoms. Here we present the case of a 52-year-old Greek female patient with GIST neoplasm of the jejunum, who attended the Emergency Department of our Hospital with indigestion and abdominal distention as the only symptoms. This is, to our knowledge, the second GIST tumour of the jejunum ever reported in Greece and the first with atypical symptomatology. Key words: GIST, jejunum, CD117, imatinib
Introduction The term gastrointestinal stromal tumours (GIST) was introduced by Mazur and Clark to characterise a new category of gastrointestinal neoplasms in 1983 [1]. They represent rare malignancies of mesenchymal origin that can appear at any site of the gastrointestinal tract. In descending order of frequency they involve the stomach, the small intestine, the colorectal area and the esophagus [2,3]. Here we present the case of a 52-year-old Greek female patient, who was diagnosed with GIST of the jejunum and attended the Emergency Department complaining about indigestion and abdomen dilatation, and we attempt a small review of the literature regarding GISTs of the jejunum.
Case report A 52-year-old Greek female patient with free medical history attended the Emergency Department, due to dyspeptic symptoms and abdomen dilatation. The symptoms had started two months before admission and did not subside Georgios Zacharis Department of General Surgery, St. Andrew’s General Hospital, Patras, Greece Nada Zacharis GP, Internal Medicine, Patras, Greece Charalampos Potsios Kalavryta General Hospital, Kalavryta, Greece Panagiota Xaplanteri Technological Educational Institute of Western Greece, Nursery School, Patras, Greece Corresponding author: George Zacharis, Department of General Surgery, St. Andrew’s General Hospital, Patras, Greece Tel.: 0030-2610-322362 Fax: 0030-2610-322362 E-mail: [email protected] Received 26 Sept 2016; Accepted 25 Oct 2016
Hellenic Journal of Surgery 89
with symptomatic therapy. The vital signs on admission were normal, while physical examination revealed a hard palpable mass in the lower abdomen. The patient had normal blood values and the laboratory findings showed white blood cell count 9,500 cells/mm3 (normal values 4,000-11,000 cells/mm3), hemoglobin 13.2 gr/dl (normal values 11.8-17.8 gr/dl) and hematocrit 39.5% (normal values 36-47%). The subsequent ultrasonography of the upper and lower abdominal area revealed a mass measuring 16×12 cm. The Computed Tomography of the abdomen and retroperitoneal space that followed revealed the presence of a tumour probably of mesenchymal origin. The patient underwent surgery and the excision of a neoplasm with dimensions 28×21×8 cm, which originated from the
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