Gastrointestinal Stromal Tumor (GIST): Case Study

Abstract

A 38-year-old male presented with a complaint of upper GIT bleeding. The patient is an alcoholic and a smoker for the last 5 years. The patient had vomited blood for the last three days. Endoscopy, Biopsy, Esophagogastroduodenoscopy and CT scan of abdomen and pelvis with IV contrast were recommended. After initial examination and reports, the patient was diagnosed with Gastrointestinal Stromal Tumor. Gastrointestinal stromal tumor was found that was spindle cell type, unifocal and low grade with mitotic speed of 2-3 /5 mm2.The tumor originated in the gastric submucosa and spread to the pericolic fat omentum. The tumor was large, being 9.5cm cm and 6.5 x 5.5 cm in greatest dimension measurements. The tumor measured more than 5 cm, but was less than 10 cm in diameter. The overlying gastric mucosa showed focal mild chronic inflammation. Heliobacter pylori and focal intestinal metaplasia was noted. As a treatment for gastrointestinal stromal tumor, surgery was recommended to remove the large exophytic gastric mass. After surgery, heterologous fragments were received. The mass of the tumor was 0.8cm with a mitotic rate of 2-3 /5 mm2 per 10 high-power fields (HPF). The examination and diagnosis also included some special studies such as immunohistochemistry assay. However, no mutational analysis test was performed. Immunohistochemistry assay was positive for C-KIT (CD117), CD34 and DOG1.