scholarly journals Accessory spleen originating from the intrinsic muscularis of the stomach misdiagnosed as gastrointestinal stromal tumor: a case report

2020 ◽  
Vol 48 (8) ◽  
pp. 030006052093530
Author(s):  
Jing Zhang ◽  
Jin-Wei Zhong ◽  
Guang-Rong Lu ◽  
Yu-Hui Zhou ◽  
Zhan-Xiong Xue ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumor ◽  
Clinical Symptoms ◽  
Accessory Spleen ◽  
Gastric Fundus ◽  
Stromal Tumor ◽  
Pathological Examination ◽  
Gastric Body ◽  
Spleen Tissue ◽  
Muscular Layer ◽  
Gastric Submucosal Tumors

A 34-year-old man presented to our hospital with a 2-month history of repeated dull upper abdominal pain. Gastroscopy and endoscopic ultrasonography indicated a hemispherical mass at the junction of the greater curvature and the gastric fundus, with hypoechogenicity originating from the intrinsic muscular layer. He was diagnosed with a gastric body submucosal lesion and gastrointestinal stromal tumor, and underwent endoscopic full-thickness resection. However, postoperative pathological examination of the mass unexpectedly revealed heterotopic spleen tissue (accessory spleen). Intragastric ectopic spleen tissue originating from the intrinsic muscular layer of the stomach is a rare clinical condition, with no specific clinical symptoms. This finding is of great clinical significance for the identification of gastric submucosal tumors.

scholarly journals TOMOGRAPHIC FINDINGS OF GASTRIC GASTROINTESTINAL STROMAL TUMOR AND CORRELATION WITH THE MITOTIC INDEX

2013 ◽  
Vol 50 (4) ◽  
pp. 244-250 ◽  
Author(s):  
Gustavo Lemos PELANDRÉ ◽  
Maria Célia DJAHJAH ◽  
Emerson Leandro GASPARETTO ◽  
Marcelo Souto NACIF ◽  
Edson MARCHIORI ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumor ◽  
Mitotic Index ◽  
Statistical Correlation ◽  
Gastric Fundus ◽  
The Body ◽  
Stromal Tumor ◽  
Gastric Body ◽  
Dense Area ◽  
Stromal Tumors ◽  
Mesenteric Fat

ContextGastrointestinal stromal tumors are uncommon abdominal neoplasms and can affect any portion of the gastrointestinal tract.ObjectivesDescribe the tomographic findings of the gastrointestinal stromal tumor of gastric origin, correlating it with the mitotic index.MethodsTwenty-one patients were selected within the period of January 2000 and 2008, with histopathological and immunohistochemical diagnosis of gastric gastrointestinal stromal tumors, who presented computed tomography done before the treatment. The tomographic variables analyzed were lesion topography, dimensions, contours, morphology, pattern and intensity enhancement through venous contrast, growth pattern, invasion of adjacent organs, presence of ulceration, fistula, calcifications, infiltration of mesenteric fat, lymphadenopathy and metastasis. The mitotic index was determined through optic microscopy, counting the number of mitosis figures in 50 high power fields.ResultsThe tumors were located in the body (66.7%) or gastric fundus (33.3%), with dimensions varying between 4.2 and 21.2 cm (average of 10.5 cm). The growth was predominantly extraluminal (47.6%) or intra/extra luminal (28.6%). The enhancement by venous contrast was heterogeneous in 66.7%. The statistical analysis showed that irregular morphology (P = 0.027) and infiltration of mesenteric fat (P = 0.012) presented correlation with the high mitotic index.ConclusionsIn the present study, most part of the tumors were located in the gastric body, with average size of 10.5 cm, presenting central hypo dense area, heterogeneous enhancement through contrast and predominantly extra luminal growth. Irregular morphology and infiltration of mesenteric fat present statistical correlation with high mitotic level.

scholarly journals An extremely rare case of a gastric accessory spleen: case report and review of the literature

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guiqin Chen ◽  
Lei Nie ◽  
Tijiang Zhang
Keyword(s):  
Rare Case ◽  
Accessory Spleen ◽  
Gastric Fundus ◽  
Pathological Examination ◽  
Review Of The Literature ◽  
Gastric Bleeding ◽  
Computed Tomographic ◽  
Normal Spleen ◽  
Elevated Lesion ◽  
Lesser Curvature

Abstract Background The accessory spleen has no anatomical or vascular relationship with the normal spleen, The tissue structure and physiological function of the accessory spleen are the same as those of the normal spleen, which usually locate in the splenic hilum and the tail of the pancreas. The aims of this manuscript are to present a rare case of the gastric accessory spleen and a review of the literature. Case presentation A 19-year-old male patient was sent to the emergency department with stomach bleeding after drinking alcohol. The computed tomographic scan showed a 1.2 cm × 1.7 cm mass at the lesser curvature of the gastric fundus. Gastrointestinal endoscopy displayed a submucosal elevated lesion on the gastric fundus, and gastrectomy was performed. Postoperative pathological examination proved an accessory spleen in the stomach. The postoperative course was uneventful, and the patient was discharged on the 6th day after the surgery. Conclusions The accessory spleen at the fundus of stomach is extremely rare, especially in this case, which is accompanied by acute gastric bleeding, and it is difficult to diagnosis before operation. Many literatures reported that it was misdiagnosis as tumor, so it is necessary to diagnose accessory spleen correctly.

scholarly journals Hybrid NOTES: Complete Endoscopic Resection of the Gastric Wall Assisted by Laparoscopy in a Gastric Fundus Gastrointestinal Stromal Tumor

2018 ◽  
Vol 26 (3) ◽  
pp. 215-217
Author(s):  
João Fernandes ◽  
Diogo Libânio ◽  
Sílvia Giestas ◽  
Tarcísio Araújo ◽  
José Ramada ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumor ◽  
Endoscopic Resection ◽  
Gastric Wall ◽  
Gastric Fundus ◽  
Stromal Tumor ◽  
Hybrid Notes

scholarly journals A Giant Gastrointestinal Stromal Tumor of the Stomach with Extramural Growth

2016 ◽  
Vol 10 (2) ◽  
pp. 344-351 ◽  
Author(s):  
Ryosuke Miyazaki ◽  
Seiji Arihiro ◽  
Eri Hayashi ◽  
Takuya Kitahara ◽  
Sayumi Oki ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumor ◽  
Tumor Resection ◽  
Partial Gastrectomy ◽  
Major Axis ◽  
Anterior Wall ◽  
Stromal Tumor ◽  
Gastric Body ◽  
Abdominal Organs ◽  
Loss Of Appetite ◽  
Upper Abdominal

A 76-year-old man presented to our hospital with abdominal distention and loss of appetite. The 10% of weight lost relative to this patient in 1 month. Abdominal computed tomography and magnetic resonance imaging revealed a giant mass, with a major axis of 23 cm, containing solid components, not involving the upper abdominal organs. Esophagogastroduodenoscopy showed extramural compression from the middle gastric body to the antrum, as well as a normal mucosal surface. These findings were suggestive of a gastrointestinal stromal tumor attached to the anterior wall of the stomach without metastasis or invasion. Partial gastrectomy was performed for tumor resection, and the patient was subsequently treated with adjuvant imatinib. We report a rare case of a large extramural gastrointestinal stromal tumor of the stomach that was larger than 20 cm in diameter and present a pertinent literature review.

scholarly journals Gastric carcinoma with a gastrointestinal stromal tumor

2018 ◽  
Vol 34 ◽  
pp. 15-19
Author(s):  
Sen Liu ◽  
Hongyu Liu ◽  
Yunlong Dong ◽  
Fengbiao Wang ◽  
Huijuan Wang ◽  
...  
Keyword(s):  
Gastric Carcinoma ◽  
Gastrointestinal Stromal Tumor ◽  
High Throughput ◽  
High Throughput Sequencing ◽  
Neuroendocrine Differentiation ◽  
Tp53 Gene ◽  
Gastric Fundus ◽  
Gastric Antrum ◽  
Stromal Tumor ◽  
Sequencing Analysis

Gastric carcinoma (GC) with gastrointestinal stromal tumor (GIST) is encountered very rarely in the clinic, and few cases have been reported in the literature. Here, we present a case involving a 72-year-old man who was diagnosed with gastric antrum adenocarcinoma accompanied by neuroendocrine differentiation and a GIST in the fundus, according to a preoperative examination and postoperative pathology. The patient then underwent a distal radical gastrectomy and GIST resection. After the operation, the patient was administered combined chemo-radiotherapy and subsequently underwent a 9-month follow-up examination. The gene mutations involved in this case were explored via high-throughput sequencing. The high-throughput gene mutation analysis indicated an exon5 mutation in the TP53 gene and copy number amplification of FGF19, CCND1, and FGFR2 in the gastric antrum adenocarcinoma. A gene sequencing analysis of the gastric fundus stromal tumor demonstrated an exon11 non-frame shift deletion mutation in the KIT gene. These findings suggested that this patient’s cancer might be sensitive to AZD1775 (a TP53-targeted drug) or targeted drugs such as FGF19, CCND1 and FGFR2, and should be sensitive to imatinib.

scholarly journals A diaphragmatic tumor mimicking gastric neoplasm: a clinical case report

2021 ◽  
Vol 49 (7) ◽  
pp. 503-507
Author(s):  
P. A. Burko ◽  
M. G. Fedorova ◽  
R. R. Iliasov ◽  
I. N. Mozhzhukhina
Keyword(s):  
Clinical Case ◽  
Clinical Symptoms ◽  
Clinical Status ◽  
Distant Metastases ◽  
Mass Effect ◽  
Gastric Fundus ◽  
Careful Consideration ◽  
Gastric Neoplasm ◽  
Pathological Examination ◽  
Diaphragmatic Tumor

The vast majority of patients with tumors arising from the diaphragm do not have any specific clinical symptoms, therefore, computed tomography (CT) and magnetic resonance imaging (MRI) are the techniques required for the diagnosis. This is particularly relevant when a  pathological mass has grown to an extent producing a “mass effect” on the adjacent organs. In some cases, clinical symptoms of arise due to the local invasion of the neoplasm to the adjacent tissues or distant metastases. We present a rare clinical case of a mesenchymal diaphragmatic tumor in a  34-year-old patient. After a  review of her clinical status and imaging of the abdomen, including CT and MRI, the preliminary diagnosis of the gastric neoplasm of uncertain behavior (D37.1) was made, despite the initial diagnostic assumption of the exogastric location of the mass based on MRI. After careful consideration of the diagnostic assessment results, a  multidisciplinary decision was made to perform laparoscopic resection of the mass. The intraoperative finding was a  tumor originating from the left diaphragmatic cupula with no involvement of the stomach. The patient's recovery was uneventful. Pathological examination revealed a solitary calcifying fibrous tumor of the diaphragm. This clinical case shows that a  mass arising from the diaphragm can mimic one arising from the gastric fundus, leading to an incorrect diagnosis and subsequent inappropriate management.

scholarly journals S2932 Ectopic Spleen Tissue Mimicking Gastrointestinal Stromal Tumor, a Case Report of a Gastric Subepithelial Lesion

2020 ◽  
Vol 115 (1) ◽  
pp. S1540-S1540
Author(s):  
Estefania M. Flores ◽  
Alexander L. Nguyen ◽  
Karol Quelal ◽  
Ishaan Vohra ◽  
Bashar Attar
Keyword(s):  
Case Report ◽  
Gastrointestinal Stromal Tumor ◽  
Stromal Tumor ◽  
Spleen Tissue ◽  
Ectopic Spleen ◽  
Subepithelial Lesion

scholarly journals Synchronous Gastric Gastrointestinal Stromal Tumor and Colon Adenocarcinoma: A Case Report

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Thivi Vasilakaki ◽  
Kalliroi Koulia ◽  
Aikaterini Tsavari ◽  
Elissavet Arkoumani ◽  
Efstratios Kouroumpas ◽  
...  
Keyword(s):  
Gastrointestinal Stromal Tumor ◽  
Regional Lymph Node ◽  
Wedge Resection ◽  
Rare Event ◽  
Colon Adenocarcinoma ◽  
Additional Treatment ◽  
Stromal Tumor ◽  
Gastric Body ◽  
Ascending Colon ◽  
Mesenchymal Tumors

Gastrointestinal stromal tumors (GISTs) represent the majority of primary mesenchymal tumors of the gastrointestinal tract. They are generally considered to be solitary tumors and therefore the synchronous occurrence with other primary malignancies of gastrointestinal track is considered a rare event. Here we present the case of a 75-year-old man admitted to our hospital with a 10-day history of gastrointestinal bleeding. Colonoscopy revealed an ulcerative mass of 4 cm in diameter in the ascending colon. Gastroscopy revealed a bulge in the gastric body measuring 1 cm in diameter with normal overlying mucosa. Surgical intervention was suggested and ileohemicolectomy with regional lymph node resection along with gastric wedge resection was performed. Pathologic examination of the ascending colon mass showed an invasive moderately differentiated adenocarcinoma stage III B (T3N1M0). Grossly resected wedge of stomach showed a well circumscribed intramural tumor which microscopically was consistent with essentially benign gastrointestinal stromal tumor (according to Miettinen criteria). The patient did not receive additional treatment. Two years later the patient showed no evidence of recurrence or metastasis.

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