A Case Report of an Exceptionally Huge Gastrointestinal Stromal Tumor (GIST) in a Tertiary Health Facility in South West Nigeria

Abstract

Background: Gastrointestinal stromal tumors (GIST) represent mesenchymal tumors located in the digestive tract wall, with the possibility of alternate locations such as the caecum or the mesentery. This is an uncommon gastrointestinal tumor that most commonly arises in the stomach. It poses a diagnostic challenge due to the variability of immunohistochemistry and cytogenetics of the tumors across patients. Treatment options include surgery and neoadjuvant chemotherapy. Case Presentation: A 58-year-old woman presented with complaints of early satiety of 6 months, left hypochondriac swelling of 5 months, and easy fatigability of 1 month's duration. Imaging revealed an enlarged stomach, with a huge mass (174 x 122) mm arising from the greater curvature of the body of the stomach and growing endophytically into the gastric lumen. Histopathological exam confirmed a diagnosis of high-grade GIST with moderate spleen congestion. The patient underwent tumor resection and has been compliant with chemotherapy (imatinib). Conclusion: This case report highlights the presentation and management of a rare and exceptionally large gastrointestinal stromal tumor (GIST) in a low-middle-income healthcare setting.  The rare gastrointestinal tumor, GIST, presents with nonspecific symptoms; therefore, clinicians must have a high index of suspicion, with prompt diagnosis and initiation of treatment. A multidisciplinary approach in management is key to good outcomes. In addition, this report contributes to the global data on GIST, especially in our environment, where there is a paucity of data on GIST presentations.