Heavily Calcified Gastrointestinal Stromal Tumour of Stomach: A Diagnostic Dilemma

2021 ◽  
Author(s):  
Bappaditya Har ◽  
Vinay Kumar Kapoor ◽  
A Behari
Keyword(s):  
Gastrointestinal Stromal Tumour ◽  
Gastric Gist ◽  
Dystrophic Calcification ◽  
Sleeve Resection ◽  
High Power Field ◽  
Mesenchymal Tumour ◽  
En Bloc ◽  
Diagnostic Dilemma ◽  
Cystic Component ◽  
Gastric Mass

Abstract Gastrointestinal stromal tumours (GIST) are the most common mesenchymal tumour of gastrointestinal tract and the stomach being the most commonly involved organ. Focal calcification may be seen in GIST but prominent or heavy calcification is rare. Gastric mass with prominent calcification on imaging may create a diagnostic dilemma. We present a rare case of gastric GIST with heavy calcification in a 55 years old female presenting with abdominal lump. Computed tomography (CT) showed a large heterogenous juxta gastric mass with solid-cystic component with heavy calcification. She underwent laparotomy and en-bloc gastric sleeve resection with the mass. Microscopic examination showed tumour with spindle cell and calcification with mitotic index of 6/50 High power field. Immunoreactivity with Vimentin, CD34 and DOG 1 confirmed diagnosis of GIST. Dystrophic calcification of necrotic or degenerative tissue is thought to be cause of calcification in GIST. Very few cases of heavily calcified GIST have been reported in literature, our case is of interest because presence of solid cystic component and a huge size ~ 14 cm (longest diameter).

scholarly journals Gastrointestinal Stromal Tumour with Synchronous Bone Metastases: A Case Report and Literature Review

2017 ◽  
Vol 10 (1) ◽  
pp. 66-76 ◽  
Author(s):  
Philippe Rochigneux ◽  
Lénaig Mescam-Mancini ◽  
Delphine Perrot ◽  
Erwan Bories ◽  
Laurence Moureau-Zabotto ◽  
...  
Keyword(s):  
Case Report ◽  
Partial Response ◽  
Literature Review ◽  
Bone Metastases ◽  
Unusual Case ◽  
Gastrointestinal Stromal Tumour ◽  
Gastric Gist ◽  
Gastrointestinal Stromal Tumours ◽  
Exon 11 ◽  
Mesenchymal Tumours

Gastrointestinal stromal tumours (GISTs) are mesenchymal tumours of the digestive tract, derived from Cajal interstitial cells. Bone metastases are very rare, and there is no consensus regarding their treatment. Here, we present the unusual case of a 66-year-old man with a gastric GIST with synchronous bone and liver metastases, fully documented at the pathological and molecular levels with a KIT exon 11 mutation. After 9 months of imatinib, the scanner showed a 33% partial response of target lesions. We also review the literature and describe the characteristics, treatment, and outcome of all cases previously reported.

Case of focal dystrophic calcification in the peritarsal soft tissues of a horse

2019 ◽  
Vol 7 (3) ◽  
pp. e000808
Author(s):  
Michael Joseph De Cozar ◽  
Elizabeth Barr
Keyword(s):  
Connective Tissue ◽  
Soft Tissues ◽  
Flexor Tendon ◽  
Distal Tibia ◽  
Central Area ◽  
Dystrophic Calcification ◽  
En Bloc ◽  
Old Irish ◽  
And Cartilage ◽  
Firm Mass

A 12-year-old Irish sports horse gelding presented with a recently developed oval firm mass at the plantaromedial aspect of right tarsus, located between the gastrocnemius and deep digital flexor tendon. At presentation, the horse was mildly right hind lame, with no exacerbation with flexion. Radiography and ultrasonography revealed an ovoid mineralised mass within soft tissues plantaromedially to tarsus and distal tibia and not associated with tarsal sheath or calcaneal bursa. Due to mild intermittent lameness and concerns regarding possibility for further increase in size, the horse underwent en bloc removal of the calcified mass under general anaesthesia. Histopathology showed the mass contained fibrous reactive connective tissue, undergoing bone and cartilage metaplasia and degeneration, with a central area of calcified bone and surrounding region of mononuclear inflammation. These characteristics although reminiscent of calcinosis circumscripta were diagnosed as focal dystrophic calcification. The horse made a full recovery and returned to a normal exercise level.

scholarly journals Gastrointestinal Stromal Tumor of the Stomach with an Abscess Excised by Laparoscopic Surgery

2016 ◽  
Vol 10 (2) ◽  
pp. 399-405 ◽  
Author(s):  
Yoshiaki Maeda ◽  
Toshiki Shinohara ◽  
Tomonari Katayama ◽  
Akihisa Nagatsu ◽  
Noriaki Futakawa ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Ct Scan ◽  
Wedge Resection ◽  
Gastric Wall ◽  
Laboratory Data ◽  
Needle Aspiration ◽  
Gastric Gist ◽  
Abdominal Abscess ◽  
En Bloc ◽  
Lesser Curvature

Gastrointestinal stromal tumors (GISTs) of the stomach presenting as an intra-abdominal abscess are extremely rare. We herein report a case that underwent successful laparoscopic resection of gastric GIST presenting with an intra-abdominal abscess. A 70-year-old man presented with a 3-day history of acute upper abdominal pain with a fever. Laboratory data showed an elevated white blood cell count and C-reactive protein level. A CT scan revealed a mass of mixed solid and fluid components, measuring 5.5 cm, in the adjacent lesser curvature of the stomach. He was diagnosed as having an intra-abdominal abscess, and antibiotic therapy was administered. Consequently, his symptoms were relieved and a CT scan on the 7th day showed that the mass reduced and became homogenous. According to the results of a fine-needle aspiration biopsy, the tumor was suspected to be a GIST. Laparoscopic surgery with the 5-port approach was performed. The tumor existed in the lesser curvature of the stomach, and was excised en bloc with the omentum and gastric wall by wedge resection. The tumor measured 3.0 cm in diameter and originated from the serosal layer of the stomach. Histological findings showed spindle cells with a stromal growth pattern that was positive for c-kit (CD 117) and CD 34. The postoperative course was uneventful, and no recurrence has been noted in the 2 years since the operation. This is the first report of a case with gastric GIST with an intra-abdominal abscess that was successfully treated by laparoscopic surgery.

scholarly journals Perioperative and Oncological Outcome of Laparoscopic Resection of Gastrointestinal Stromal Tumour (GIST) of the Stomach

2009 ◽  
Vol 2009 ◽  
pp. 1-7 ◽  
Author(s):  
Ulrich Ronellenfitsch ◽  
Wilko Staiger ◽  
Georg Kähler ◽  
Philipp Ströbel ◽  
Matthias Schwarzbach ◽  
...  
Keyword(s):  
Laparoscopic Resection ◽  
Gastrointestinal Stromal Tumour ◽  
Operation Time ◽  
Oncologic Outcome ◽  
Oncological Outcome ◽  
Stromal Tumour ◽  
Perioperative Outcomes ◽  
Gastric Gist ◽  
Gastric Gists

Background. Surgery remains the only curative treatment for gastrointestinal stromal tumour (GIST). Resection needs to ensure tumour-free margins while lymphadenectomy is not required. Thus, partial gastric resection is the treatment of choice for small gastric GISTs. Evidence on whether performing resection laparoscopically compromises outcome is limited. Methods. We compiled patients undergoing laparoscopic resection of suspected gastric GIST between 2003 and 2007. Follow-up was performed to obtain information on tumour recurrence. Results. Laparoscopic resection with free margins was performed in 21/22 patients. Histology confirmed GIST in 17 cases, 4 tumours were benign neoplasms. Median operation time and postoperative stay for GIST patients were 130 (range 80–201) mins and 7 (range 5–95) days. Two patients experienced stapler line leakage necessitating surgical revision. After median follow-up of 18 (range 1–53) months, no recurrence occurred. Conclusions. Laparoscopic resection of gastric GISTs yields good perioperative outcomes. Oncologic outcome needs to be assessed with longer follow-up. For posterior lesions, special precaution is needed. Laparoscopic resection could become standard for circumscribed gastric GISTs if necessary precautions for oncological procedures are observed.

Purely Intraventricular Desmoplastic Infantile Astrocytoma

2021 ◽  
Author(s):  
Giovanni Federico Nicoletti ◽  
Giuseppe Emmanuele Umana ◽  
Carmelo Riolo ◽  
Gaetano Magro ◽  
Giovanni Bartoloni ◽  
...  
Keyword(s):  
Lateral Ventricle ◽  
En Bloc Resection ◽  
External Ventricular Drainage ◽  
Lower Limbs ◽  
World Health ◽  
En Bloc ◽  
Foramen Of Monro ◽  
First Case ◽  
Left Lateral Ventricle ◽  
Cystic Component

AbstractDesmoplastic infantile astrocytomas (DIAs) are rare pediatric tumors characterized by superficial brain cortex involvement, along with the meninges of the supratentorial compartment, and are classified as grade I neoplasms according to the 2016 World Health Organization. A 5-year-old female patient was admitted to our unit with abnormal decorticate posturing, bilateral mydriasis with weak pupillary light reflex, and brisk lower limbs reflexes. Her medical history was unremarkable. Magnetic resonance imaging of the brain revealed a massive lesion with bilateral intraventricular growth mainly prevailing on the left and involving the ipsilateral foramen of Monro. After external ventricular drainage positioning, Dandy's transfrontal transcortical approach to the left lateral ventricle, a meticulous ependymal microsurgical dissection of the lesion was performed, resulting in an excision of the cystic component of the left lateral ventricle. A gross total removal of the lesion was performed with an en bloc resection of the deeper cystic part. Thirty days after surgery, the patient presented with fluent speech, conserved axial, and extremity sensorimotor functions, except a mild central facial paresis which progressively improved. To the best of our knowledge, this is the first case of DIA characterized by purely intraventricular growth. Tumor recurrence, although considered rare, represents an unpredictable event. Therefore, an adequate follow-up must be reserved for each patient.

scholarly journals Fecal Halitosis: A Case Report

2017 ◽  
Vol 6 (1) ◽  
pp. 34-38
Author(s):  
Suttam Kumar Biswas ◽  
Shilpi Rani Roy ◽  
Arup Roton Paul
Keyword(s):  
Adjuvant Chemotherapy ◽  
Rare Complication ◽  
Anal Verge ◽  
En Bloc Resection ◽  
Sleeve Resection ◽  
Gastrocolic Fistula ◽  
En Bloc ◽  
Term Survival ◽  
Diffuse Abdominal Pain ◽  
Histopathological Report

There are many causes of fecal halitosis like poor oral hygene, bowel obstruction, GERD, oral malignancy, liver failure etc. Gastrocolic fistula is a rare cause of fecal halitosis. Gastrocolic fistula is a rare complication of adenocarcinoma of the colon. Despite radical resections, these patients usually have a poor prognosis with a mean survival of 23 months and long-term survival is rarely reported. A 40-year-old man of Netrokona district presented with diffuse abdominal pain, vomiting, fecal smell from mouth and weight loss for 3 months. A Barium enema revealed fistulous communication in between left colic flexure upto body of the stomach. Upper gastrointestinal tract endoscopy done repeatedly but report was normal. Colonoscopic report was a growth seen at 60 cm from anal verge and the scope couldn't be passed up. Histopathological report of colonoscopic biopsy was non specific chronic colitis. His part of colon, sleeve resection of stomach were resected en bloc. As per histopathological report, sections from the transvers colon tumor revealed an adenocarcinoma composed of malignant glands with an infiltrative pattern. Adjuvant chemotherapy with capecitabine and oxaliplatin was administered after surgery. Our patient is alive. En bloc resection with adjuvant chemotherapy offers the best treatment option for gastrocolic fistulas. This is one of the patients with greater survival reported in the medical literature. CBMJ 2017 January: Vol. 06 No. 01 P: 34-38

Recurrent perineal aggressive angiomyxoma: dilemma in diagnosis and outcome of this rare disease

2021 ◽  
Vol 14 (2) ◽  
pp. e238722
Author(s):  
Nitin Paul Ambrose ◽  
Victor Vijay Coelho ◽  
Beulah Roopavathana ◽  
Suchita Chase
Keyword(s):  
Surgical Excision ◽  
Perineal Hernia ◽  
Complete Resection ◽  
Aggressive Angiomyxoma ◽  
Immunohistochemical Examination ◽  
Male Population ◽  
Mesenchymal Tumour ◽  
Diagnostic Dilemma ◽  
Perineal Region ◽  
High Chance

Aggressive angiomyxoma (AAM) is a very rare, benign, locally infiltrative mesenchymal tumour with a high chance of recurrence following surgical excision. In the male population, it is so rare that less than only 50 cases have been reported so far. We present a case of a large recurrent perineal AAM in a man who presented with swelling in the perineal region following surgical excision 3 years ago. After evaluation, the diagnostic dilemma of a possible perineal hernia or recurrence remained. Surgical exploration ruled out hernia and the tumour was excised with difficulty. Immunohistochemical examination showed tumour cells with diffuse nuclear positivity for oestrogen receptor and patchy cytoplasmic positivity for desmin (A2). Histological and immunohistochemical features confirmed the diagnosis. Being very rare, AAMs need to be considered as a differential diagnosis of pelvic/perineal tumours among males. With no standardised therapy for AAM, complete resection would be the goal of therapy.

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