GASTROINTESTINAL STROMAL TUMOR (GIST): A RARE CASE OF SEVERE GASTRIC HAEMORRHAGE

Abstract

Introduction: A rare case of gastrointestinal stromal tumor (GIST) provoking a severe gastric bleeding is reported.

Case report and results: The Autors report on the case of a 53-year-old male patient who presented with ematemesis, melena and severe acute anemia (Hb: 6 g/dl). EGDS disclosed a protruding lesion centrally ulcerate, of 7 cm in size, localized in the upper half of gastric corpus. Multiple endocopic biopsies were negative for neoplastic changes. Because of further gastric bleeding, a total gastrectomy with “Roux-en-Y” reconstruction was performed in urgency. GIST of smooth muscle was diagnosed by histological and immunohistochemical postoperatory examination.

Discussion: Gist are neoplasms arising from connctive tissue elements of gastrointestinal wall, wich represent about 2% of GI-tract malignant tumor. Tumor size of 5 cm or grater, elevated mitotic count, histological indifferentiation are significantly associated with a shorter recurrence-free survival. GISTs are rarely cause of an inarrestable gastric bleeding. For gastroenterological surgeons it is critical to select the most suitable surgical procedure. In our case, 9 months after gastrectomy the patient is well, in spite the severe clinical background and the malignancy degree.

Conclusion: The GISTs have to be taken into account in the differantial diagnosis of GI-tract tumors if endoscopic biopsies are negative for malignancy. In our opinion, total or partial gastrectomy fro gastric should be preferred. Moreover, a close follow up is recommended.