scholarly journals Coexistence of Primary GEJ Adenocarcinoma and Pedunculated Gastric Gastrointestinal Stromal Tumor

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Aroub Alkaaki ◽  
Basma Abdulhadi ◽  
Murad Aljiffry ◽  
Mohammed Nassif ◽  
Haneen Al-Maghrabi ◽  
...  
Keyword(s):  
Digestive System ◽  
Wedge Resection ◽  
Gastroesophageal Junction ◽  
Pathological Examination ◽  
Gastric Gist ◽  
Gi Tract ◽  
Mesenchymal Tumors ◽  
Gastric Mass ◽  
Greater Curvature ◽  
Submucosal Resection

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the digestive system, although they account for only 0.1–3% of all gastrointestinal (GI) malignancies. They can arise anywhere along the GI tract with gastric predominance. Concurrent occurrence of GIST and gastroesophageal junction (GEJ) neoplasm is rare. We report a 55-year-old gentleman presenting with a polyp at the GEJ and a synchronous, large, and pedunculated gastric mass at the greater curvature. Those were treated with a wedge resection of the gastric pedunculated mass with negative margins along with transgastric submucosal resection of the GEJ polyp. Pathological examination confirmed synchronous invasive GEJ adenocarcinoma and a high-grade gastric GIST.

scholarly journals Laparoscopic gastric wedge resection as the method of choice in the treatment of gastrointestinal stromal tumors: A case report

2016 ◽  
Vol 144 (3-4) ◽  
pp. 211-214
Author(s):  
Dejan Stevanovic ◽  
Dragos Stojanovic ◽  
Damir Jasarovic ◽  
Nebojsa Mitrovic ◽  
Zorana Bokun-Vukasinovic
Keyword(s):  
Gastrointestinal Tract ◽  
Gastrointestinal Stromal Tumors ◽  
Histological Grade ◽  
Wedge Resection ◽  
Gastric Gist ◽  
Histopathological Analysis ◽  
Primary Therapy ◽  
Mesenchymal Tumors ◽  
Stromal Tumors ◽  
Common Group

Introduction. The gastrointestinal stromal tumors (GIST) are the most frequent mesenchymal tumors of the gastrointestinal tract. The surgery of resectable gastric GIST is the primary therapy for these tumors, but the decision regarding the surgical radicality of the procedures is still a point of discussion among surgeons and oncologists. Case Outline. A 74-year-old patient was admitted to hospital with signs of bleeding from the upper parts of the gastrointestinal tract. Urgent gastroscopy was performed and a subepithelial gastric lesion with bleeding ulceration was noted in the region of the fornix. A computed tomography scan of the abdomen showed a tumor in the fornix region with the dimensions of 48 ? 32 mm, which was growing mostly intraluminally. After an adequate preoperative preparation the patient underwent a laparoscopic wedge resection of gastric fornix with intramural tumor lesion. The histopathological analysis of the specimen showed a well differentiated GIST (histological grade G1), of the spindle cell type. Based on the immunohistochemical analysis of the specimen it was concluded that the patient was in the IA stage of the disease with a low risk of malignant progression. In the population of patients with GIST, this is the most common group (43%), with low malignant potential, and relapses present in only 3.6% of cases. The patient started with oral food intake on the first postoperative day, the first bowel movement occurred 36 hours after surgery, and the patient was released from hospital on the fourth postoperative day. Conclusion. Based on the aforementioned, we consider that the laparoscopic gastric wedge resection is a safe and efficient surgical procedure. This is primary therapy for most common group of patients with resectable gastric GIST.

scholarly journals Laparoscopic Transgastric Resection of a Large Gastric GIST: A Case Report and Review of Literature

2021 ◽  
Vol 07 (04) ◽  
pp. e337-e341
Author(s):  
Eham Arora ◽  
Jaini Gala ◽  
Aditya Nanavati ◽  
Arun Patil ◽  
Ajay Bhandarwar
Keyword(s):  
Case Report ◽  
Wedge Resection ◽  
Laparoscopic Approach ◽  
Posterior Wall ◽  
Needle Aspiration ◽  
Primary Treatment ◽  
Resected Specimen ◽  
Gastric Gist ◽  
Mesenchymal Tumors ◽  
Transgastric Approach

Abstract Introduction Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal (GI) tract. Their primary treatment is surgical. Case Report Here we report a case of a 36-year-old male patient who was being evaluated for weakness, anemia, and melena. Upper GI endoscopy showed a mass projecting into the lumen and an abdominal computed tomography (CT) confirmed a well-defined mass close to the lesser curvature on the posterior wall. An endoscopic ultrasound-guided fine needle aspiration suggested a diagnosis of GIST. After optimization, the patient was taken up for a laparoscopic transgastric resection of the GIST. The resected specimen measured 9.5 × 8.5 × 7.5 cm. Postoperatively, the patient recovered well and was discharged by the fifth postoperative day. Discussion While traditionally, open surgery has been advocated for GISTs, for fear of spillage and peritoneal seeding, the role of minimal access surgery has been growing in recent years. The use of a transgastric approach avoids the potential complication of luminal stenosis following a wedge resection of a tumor close to the cardia. Because lymphadenectomies are rarely required and local invasion is uncommon, a wide local resection is usually curative. Thus, a laparoscopic approach can be considered as the first line in uncomplicated GISTs, irrespective of tumor size.

SMAD4 juvenile polyposis syndrome and hereditary haemorrhagic telangiectasia presenting in a middle-aged man as a large fungating gastric mass, polyposis in both upper and lower GI tract and iron deficiency anaemia, with no known family history

2020 ◽  
Vol 13 (12) ◽  
pp. e236855
Author(s):  
Wendy Chang ◽  
Patricia Renaut ◽  
Casper Pretorius
Keyword(s):  
Family History ◽  
Autosomal Dominant ◽  
Signs And Symptoms ◽  
Juvenile Polyposis ◽  
Hereditary Haemorrhagic Telangiectasia ◽  
Gi Tract ◽  
Juvenile Polyposis Syndrome ◽  
Polyposis Syndrome ◽  
History Of ◽  
Gastric Mass

Juvenile polyposis syndrome (JPS) and hereditary haemorrhagic telangiectasia (HHT) are rare autosomal dominant diseases, where symptoms manifest at childhood. A 32-year-old man with no family history of JPS or HHT with SMAD4 gene mutation who developed signs and symptoms only at the age of 32, when he was an adult. In this article, we highlight the steps taken to diagnose this rare pathology, explain its pathophysiology and management.

scholarly journals Gastric Schwannoma: A Rare but Important Differential Diagnosis of a Gastric Submucosal Mass

2012 ◽  
Vol 2012 ◽  
pp. 1-5 ◽  
Author(s):  
William Yoon ◽  
Kari Paulson ◽  
Paul Mazzara ◽  
Sweety Nagori ◽  
Mohammed Barawi ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Surgical Resection ◽  
Treatment Options ◽  
Partial Gastrectomy ◽  
Preoperative Imaging ◽  
Mesenchymal Tumors ◽  
Gastric Schwannoma ◽  
Gastric Mass ◽  
Submucosal Mass ◽  
Slow Growing

Schwannomas are generally slow growing asymptomatic neoplasms that rarely occur in the GI tract. However, if found, the most common site is the stomach. Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, and 60–70% of them occur in the stomach. Owing to their typical presentation as submucosal neoplasms, gastric schwannomas and GISTs appear grossly similar. Accordingly, the differential diagnosis for a gastric submucosal mass should include gastric schwannomas. Furthermore, GI schwannomas are benign neoplasms with excellent prognosis after surgical resection, whereas 10–30% of GISTs have malignant behavior. Hence, it is important to distinguish gastric schwannomas from GISTs to make an accurate diagnosis to optimally guide treatment options. Nevertheless, owing to the paucity of gastric schwannomas, the index of suspicion for this diagnosis is low. We report a rare case of gastric schwannoma in 53-year-old woman who underwent laparoscopic partial gastrectomy under the suspicion of a GIST preoperatively but confirmed to have a gastric schwannoma postoperatively. This case underscores the importance of including gastric schwannomas in the differential diagnosis when preoperative imaging studies reveal a submucosal, exophytic gastric mass. For a gastric schwannoma, complete margin negative surgical resection is the curative treatment of choice.

scholarly journals A Case of Benign Schwannoma of the Ascending Colon Treated With Laparoscopic-Assisted Wedge Resection

2013 ◽  
Vol 98 (4) ◽  
pp. 315-318 ◽  
Author(s):  
Se-Jin Baek ◽  
Won Hwangbo ◽  
Jin Kim ◽  
In-Sun Kim
Keyword(s):  
Submucosal Tumor ◽  
Wedge Resection ◽  
Ascending Colon ◽  
Mesenchymal Tumors ◽  
Benign Schwannoma ◽  
S 100 ◽  
Colon And Rectum ◽  
Laparoscopic Assisted ◽  
Specific Symptoms ◽  
Diffuse Positivity

Abstract Isolated colonic schwannomas are rare gastrointestinal mesenchymal tumors. Only a small number of cases have been reported. Occurrence of these tumors is more common in the stomach than in the large intestine. These spindle cell lesions are distinct from leiomyoma, leiomyosarcoma, and gastrointestinal stromal tumors because the tumor cells have a distinct immunophenotype, with strong diffuse positivity for S-100 and vimentin, as well as corroborative negative staining of CD117 and smooth muscle markers. We present a case of colonic schwannoma in a 70-year-old woman who had no specific symptoms. The patient was diagnosed with a submucosal tumor in the ascending colon on colonoscopy and abdominal computed tomography. Laparoscopic-assisted wedge resection of colon was performed. The very rare pathologic diagnosis of ascending schwannoma was made postoperatively. This case is interesting because schwannomas of the colon and rectum are extremely rare and are treated by laparoscopic-assisted wedge resection.

scholarly journals A Rare Entity of Benign Recurring Mesenchymal Tumor of the Female Urethra

2013 ◽  
Vol 2013 ◽  
pp. 1-2
Author(s):  
Onur Telli ◽  
Haşmet Sarıcı ◽  
Berat Cem Özgür ◽  
Cem Nedim Yücetürk ◽  
Mehmet Ali Karagöz
Keyword(s):  
Lower Urinary Tract ◽  
Soft Tissue Tumor ◽  
Benign Tumor ◽  
Pathological Examination ◽  
Rare Entity ◽  
Female Urethra ◽  
Mesenchymal Tumors ◽  
Urinary Tract Symptoms ◽  
Myxoid Matrix ◽  
Lower Urinary

This is a case report of a 51-year-old female patient with benign mesenchymal tumors of paraurethral region which caused lower urinary tract symptoms. The pathological examination of the lesion was reported as angiomyxoma which is a distinct soft tissue tumor characterized by the presence of prominent myxoid matrix and numerous thin-walled blood vessels. This tumor has a predilection for the trunk, head and neck, extremities, and genitalia. It is a benign tumor, and total excision is curative. Recurrence is rare except for aggressive angiomyxomas.

scholarly journals Gastric schwannoma: a benign tumor often misdiagnosed as gastrointestinal stromal tumor

2015 ◽  
Vol 5 (3) ◽  
Author(s):  
Apurva S. Shah ◽  
Pravin M. Rathi ◽  
Vaibhav S. Somani ◽  
Astha M. Mulani
Keyword(s):  
Differential Diagnosis ◽  
Gastrointestinal Stromal Tumor ◽  
Gastrointestinal Stromal Tumors ◽  
Rare Case ◽  
Benign Tumor ◽  
Stromal Tumor ◽  
Mesenchymal Tumors ◽  
Stromal Tumors ◽  
Gastric Schwannoma ◽  
Gastric Mass

Gastric schwannomas are rare mesenchymal tumors that arise from the nerve plexus of gut wall. They present with nonspecific symptoms and are often detected incidentally. Preoperative investigation is not pathognomic and many are therefore misdiagnosed as gastrointestinal stromal tumors. We report a rare case of a 37-year old woman who underwent laparotomy for complex bilateral ovarian cyst with resection of gastric-gastrointestinal stromal tumor preoperatively, but confirmed to have a gastric schwannomas postoperatively. This case underscores the differential diagnosis of submucosal, exophytic gastric mass as schwannoma.

scholarly journals Successful revision surgery for very late-onset stomal obstruction following Gomez gastroplasty: a case report

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yudai Hojo ◽  
Yasunori Kurahashi ◽  
Toshihiko Tomita ◽  
Tsutomu Kumamoto ◽  
Tatsuro Nakamura ◽  
...  
Keyword(s):  
Revision Surgery ◽  
Preoperative Diagnosis ◽  
Late Onset ◽  
Staple Line ◽  
Weight Loss Surgery ◽  
Wedge Resection ◽  
Gastric Pouch ◽  
Sudden Onset ◽  
Gastric Body ◽  
Greater Curvature

Abstract Background Gomez gastroplasty, which was developed in the 1970s as one of the gastric restrictive surgeries for severe obesity, partitions the stomach using a stapler from the lesser towards the greater curvature at the upper gastric body, leaving a small channel. This procedure is no longer performed due to poor outcomes, but surgeons can encounter late-onset complications even decades after the surgery. Here, we report a case of very late-onset stomal obstruction following Gomez gastroplasty which was successfully treated by revision surgery. Case presentation A 58-year-old man was referred to our institution with sudden-onset nausea and vomiting. He underwent weight loss surgery in the USA in 1979, but the details of the surgery were unclear. Esophagogastroduodenoscopy demonstrated a stoma at the greater curvature of the upper gastric body, and fluoroscopy showed retention of contrast medium in the fundus and poor outflow through the stoma. Abdominal computed tomography revealed a staple line partitioning the stomach. Considering these preoperative investigation findings and the period during which the surgery was performed, the patient was diagnosed with very late-onset stomal obstruction following Gomez gastroplasty. Supporting the preoperative diagnosis, the surgical findings revealed a staple line extending from the lesser towards the greater curvature of the upper gastric body and a channel reinforced by a running seromuscular suture on the greater curvature. Moreover, gastric torsion caused by the enlarged proximal gastric pouch was found. Re-gastroplasty involving wedge resection of the original channel was performed followed by construction of a new channel. Postoperative course was uneventful, and the patient no longer had symptoms of stomal obstruction after revision surgery. Conclusions Re-gastroplasty was safe and feasible for very late-onset stomal obstruction following Gomez gastroplasty. Accurate preoperative diagnosis based on the patient’s interview and the investigation findings was important for surgical planning. A careful follow-up is required to prevent excessive weight regain after revision surgery.

Minimally Invasive Resection of Benign Gastric Tumors in Challenging Locations: Prepyloric Region or Gastroesophageal Junction

2013 ◽  
Vol 79 (10) ◽  
pp. 968-972 ◽  
Author(s):  
Christopher Armstrong ◽  
Alana Gebhart ◽  
Brian R. Smith ◽  
Ninh T. Nguyen
Keyword(s):  
Minimally Invasive ◽  
Perioperative Complications ◽  
Wedge Resection ◽  
Gastroesophageal Junction ◽  
Surgical Techniques ◽  
Surgical Approaches ◽  
Anatomic Resection ◽  
Submucosal Tumors ◽  
Gastric Tumors ◽  
Minimally Invasive Surgical

Benign gastric tumors in a prepyloric location or within 3 cm adjacent of the gastroesophageal junction (GEJ) are often challenging to resect using minimally invasive surgical techniques. The aim of this study was to examine the outcomes of patients who underwent minimally invasive enucleation or resection of benign gastric tumors at these difficult locations. The charts of patients undergoing minimally invasive resection of benign-appearing submucosal gastric tumors between June 2001 and December 2012 were reviewed. Data on tumor size and location, type of minimally invasive surgical resection, perioperative complications, 90-day mortality, pathology, and recurrence were collected. A total of 70 consecutive patients underwent laparoscopic resection of benign-appearing submucosal gastric tumors; there were 24 patients with lesions close to the GEJ and nine patients with lesions close to the prepyloric region. All lesions were successfully resected laparoscopically. For prepyloric tumors, surgical approaches included enucleation (n = 1), wedge resection (n = 2), and distal gastrectomy with reconstruction (n = 6). For tumors close to the GEJ, surgical approaches included enucleation (n = 16), wedge resection (n = 3), and esophagogastrectomy (n = 5). Complications in this series of 33 patients included late strictures requiring endoscopic dilation in three patients who underwent esophagogastrectomy. The 90-day mortality rate was zero. There were no recurrences over a mean follow-up of 15 months (range, 1 to 86 months). Minimally invasive enucleation or formal anatomic resection of submucosal tumors located adjacent to the GEJ or at the prepyloric region is safe and carries a low risk for tumor recurrence. Submucosal gastric lesions adjacent to the GEJ are amenable to laparoscopic enucleation or wedge resection unless they extend proximally into the esophagus. Prepyloric lesions often require formal anatomic resection with reconstruction.

scholarly journals Nonislet Cell Tumor Hypoglycemia

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Johnson Thomas ◽  
Salini C. Kumar
Keyword(s):  
Glucose Utilization ◽  
Cell Tumor ◽  
Gi Tract ◽  
Normal Range ◽  
Mesenchymal Tumors ◽  
Hypoglycemia Unawareness ◽  
Factor Ii ◽  
Carcinoma Of Esophagus ◽  
Poorly Differentiated ◽  
Tumor Hypoglycemia

Nonislet cell tumor hypoglycemia (NICTH) is a rare cause of hypoglycemia. It is characterized by increased glucose utilization by tissues mediated by a tumor resulting in hypoglycemia. NICTH is usually seen in large mesenchymal tumors including tumors involving the GI tract. Here we will discuss a case, its pathophysiology, and recent advances in the management of NICTH. Our patient was diagnosed with poorly differentiated squamous cell carcinoma of esophagus. He continued to be hypoglycemic even after starting continuous tube feeds and D5W. General workup for hypoglycemia was negative and insulin-like growth factor II (IGF II) was in the normal range. Hypoglycemia secondary to “big” IGF II was considered, and patient was started on steroids. His hypoglycemia resolved within a day of treatment with steroids. Initially patient had hypoglycemia unawareness, which he regained after maintaining euglycemia for 48 hours.

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