Duodenal Gastrointestinal Stromal Tumour Imitating as Pancreatic Head Tumour: A Typical Case of Whodunit

Abstract Duodenal gastrointestinal stromal tumours (D-GISTs) are rare disease. It may arise commonly from second or third part of the duodenum and can be erroneously diagnosed as a pancreatic head tumour due to proximity and morphology on imaging studies. We present a case of a sixty-year-old woman who presented with abdominal pain and was diagnosed as a case of pancreatic neuroendocrine tumour on radiologic imaging and granulomatous lesion on aspiration cytology. On laparotomy, a ~5x3 cm mass was noted in the pancreatic head and pancreatoduodenectomy was performed. Histopathology reported an exophytic GIST arising from the second part of the duodenum.Hence, D-GIST can invade into the pancreas and mimic pancreatic head tumour; therefore, these tumours should be kept in the differential diagnosis of an atypical pancreatic head mass.

Download Full-text

Large Duodenal Gastrointestinal Stromal Tumour Invading the Pancreas- A Masquerader for Pancreatic Head Mass

JOURNAL FOR CLINICAL AND DIAGNOSTIC RESEARCH ◽

10.7860/jcdr/2020/44832.14050 ◽

2020 ◽

Author(s):

Priyanka Gopinath Ghodekar ◽

Aniruddha V Bhosale ◽

Dinesh K Zirpe ◽

Bipin B Vibhute

Keyword(s):

Pancreatic Head ◽

Gastrointestinal Stromal Tumour ◽

Gastrointestinal Stromal Tumours ◽

Duodenal Gist ◽

Contrast Enhanced ◽

Immuno Histochemistry ◽

Duodenal Gists ◽

Enhanced Computed Tomography ◽

Contrast Enhanced Computed Tomography ◽

Mesenchymal Tumours

Gastrointestinal Stromal Tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract commonly arising from stomach and small intestine. Duodenal GISTs are rare. Though uncommon, GISTs can arise from the omentum, mesentery, gallbladder as well as retroperitoneum and are defined as Extra GISTs (EGIST). Authors have reported a case of large GIST arising from the second part of the duodenum and mimicking the large pancreatic head mass in a 34-year-old female patient presented with abdominal pain and vomitings. The Contrast Enhanced Computed Tomography (CECT) revealed a large enhancing mass in the pancreatico-duodenal groove not separated from pancreatic head. Whipple’s surgery was performed. Histopathology and Immuno-histochemistry report revealed the duodenal GIST with pancreatic infiltration with high risk for metastases according to mitotic index and size. Sometimes large duodenal GISTs can make the diagnosis difficult radiologically due to invasion of pancreatic head and mimic as primary pancreatic head tumour.

Download Full-text

Fine needle aspiration cytology of a clear cell (lipid-rich) pancreatic neuroendocrine tumour in a patient without von Hippel-Lindau disease

Cytopathology ◽

10.1111/j.1365-2303.2012.00975.x ◽

2012 ◽

Vol 24 (3) ◽

pp. 197-198 ◽

Cited By ~ 5

Author(s):

S. Chen ◽

H. H. Wu ◽

H. Cramer

Keyword(s):

Fine Needle Aspiration ◽

Clear Cell ◽

Neuroendocrine Tumour ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Fine Needle ◽

Von Hippel Lindau ◽

Von Hippel Lindau Disease ◽

Pancreatic Neuroendocrine Tumour ◽

Needle Aspiration Cytology

Download Full-text

Abstract #312: A Case of Silent Pancreatic Neuroendocrine Tumour of Carcinoid Variety Masquerading as an Insulinoma

Endocrine Practice ◽

10.1016/s1530-891x(20)44426-x ◽

2017 ◽

Vol 23 ◽

pp. 89-90

Author(s):

Tarik Elhadd ◽

Nour Suleiman ◽

Mohamed Bashir ◽

Emad Naem ◽

Khalid M. Ahmed ◽

...

Keyword(s):

Neuroendocrine Tumour ◽

Pancreatic Neuroendocrine Tumour

Download Full-text

Profiling of tissue inflammatory cytokine expression in a pancreatic neuroendocrine tumour mouse model identifies upregulation of the chemokine C-C motif ligand 2 (CCL2)

Endocrine Abstracts ◽

10.1530/endoabs.65.p136 ◽

2019 ◽

Author(s):

Omair Shariq ◽

Kate Lines ◽

Mark Stevenson ◽

Rajesh Thakker

Keyword(s):

Mouse Model ◽

Inflammatory Cytokine ◽

Neuroendocrine Tumour ◽

Cytokine Expression ◽

Pancreatic Neuroendocrine Tumour

Download Full-text

Fibrous Dysplasia at Unusual Anatomic Sites: A Series of 86 Cases With Emphasis on Histologic Patterns

International Journal of Surgical Pathology ◽

10.1177/1066896921997141 ◽

2021 ◽

pp. 106689692199714

Author(s):

Nicholas J. Olson ◽

Carrie Y. Inwards ◽

Doris E. Wenger ◽

Karen J. Fritchie

Keyword(s):

Bone Formation ◽

Fibrous Dysplasia ◽

Giant Cells ◽

Imaging Features ◽

Expert Consultation ◽

Imaging Studies ◽

Radiologic Imaging ◽

Type Giant ◽

Small Bones ◽

Tubular Bones

Aims. Fibrous dysplasia (FD) is a benign fibro-osseous neoplasm that most commonly arises in the ribs, femur, and craniofacial bones. We analyzed features of FD arising in the spine/short tubular/small bones of the hands/feet (STSBHF), specifically assessing for pattern of bone formation (conventional, complex/anastomosing, psammomatoid/cementum like), myxoid change, and presence of osteoclast-type giant cells. Materials and methods. A total of 1958 cases of FD were reviewed, of which 131 arose in the spine/STSBHF representing 2.5% of institutional and 10% of consultation cases, respectively. Eighty-six cases had material available for review. Anatomic sites included vertebrae ( n = 58, 67%), short tubular bones ( n = 20, 23%), and small bones of the hands/feet ( n = 8, 9%). The most common morphologic pattern of bone identified was conventional ( n = 77, 90%), followed by complex/anastomosing ( n = 22, 26%) and psammomatoid/cementum like ( n = 22, 26%). Eighteen cases (21%) had matrix-poor areas. Hypercellular areas were identified in 6 cases, 2 cases of which showed matrix-poor areas. Osteoclast-type giant cells were noted in 9 cases and myxoid change was present in 3 cases. Radiologic imaging studies available for 41 cases nearly all demonstrated features typical of FD, but the diagnosis was not predicted due to the unexpected location. Conclusions. FD arising in the spine/STSBHF is rare and frequently results in expert consultation. A significant number of cases exhibited less commonly recognized patterns of bone formation, and stromal changes including osteoclast-type giant cells, and matrix poor areas. Furthermore, imaging features in the STSBHF are often less specific. Awareness of the morphologic spectrum at these locations coupled with radiologic correlation should aid in accurate classification.

Download Full-text