scholarly journals Vagus-Preserving Proximal Gastrectomy with Double- Flap Technique for Gastrointestinal Stromal Tumor involving the Esophagogastric Junction:A Case Report

Author(s):  
Wei Peng ◽  
Yi-Kai Huang ◽  
Yong-You Wu ◽  
Wei Gong ◽  
Zheng-Rong Chen ◽  
...  

Abstract Background: Gastrointestinal stromal tumor (GIST) involving the esophagogastric junction (EGJ) is a relatively rare but thorny problem. It represents a dilemma between complete resection and impairment of quality of life (QOL) for loss of cardiac sphincter or even the whole stomach. Thus, emergence of function preserving gastrectomy is necessary and may provide partial solution to this hot potato. Here, we would like to introduce a method which successfully settle this matter through a clinical case. Case presentation: A 46-year-old male complaining of a progressive dysphagia. A huge GIST with 120mm in diameter was diagnosed by enhanced CT scan and pathological exam. Imatinib mesylate (IM) was initially prescribed, the tumor was shrank to a large extent while drug resistance emerged 6 months after therapy, leaving a mass approximately 90mm in diameter. We applied a method of vagus preserving proximal gastrectomy (VP-PG) and esophagogastrostomy with double-flap technique (DFT) for the patient. The operation was smooth and postoperative courses within a 12-months follow-up were uneventful. The patient had no digestive symptoms but slight leucopenia due to IM toxicity during this medication period. Conclusion: We consider that the application of VP-PG and DFT subsequent to neoadjuvant therapy with IM is likely to be an effective and feasible option for GISTs with EGJ involvement.

Author(s):  
Abderrahmane Jallouli ◽  
Mariama Jarti ◽  
Marj Zohour Haida ◽  
Mouna El Bouatmani ◽  
Adil Ait Errami ◽  
...  

Rectal gastrointestinal stromal tumors (GIST) are extremely rare, accounting for approximately 0.1% of all rectal tumors. Diagnosis is based on histological and immunohistochemical confirmation. We report the case of a 38-year-old patient with a rectal GIST revealed by chronic rectal bleeding associated with rectal tenesmus, abdominal pain with painful contractions and frequent evacuations evolving in a context of altered general state. Rectoscopy was used to visualize the tumor mass and to take biopsies; their histological and immunohistochemical study revealed a rectal location of a gastrointestinal stromal tumor. The extension assessment was negative. After discussion of the case in a multidisciplinary consultation meeting, management consisted of initially putting the patient on Imatinib given the large tumor size, the degree of local invasion and the location of the mass (lower rectum), with regular follow-up in order to schedule a less invasive surgical resection later. Despite the rarity of rectal GIST, early diagnosis is necessary to avoid progression to locoregional invasion complicating some surgical resections given the anatomical constraints of the pelvic region. Hence the interest of neoadjuvant therapy with tyrosine kinase inhibitors allowing in some cases a decrease in tumor volume, a regression of the degree of local invasion and a decrease in the morbidity of the surgery in order to improve the patient's quality of life.


2009 ◽  
Vol 2 ◽  
pp. CGast.S3221
Author(s):  
Abdel-Rauf Zeina ◽  
Alicia Nachtigal ◽  
Eugene Vlodavsky ◽  
Jochanan E. Naschitz

Metastatic tumors to the liver resulting in fulminant hepatic failure are a rare occurrence and have not been previously described in patients with gastrointestinal stromal tumor (GIST). A 70 year-old man was referred to hospital with postprandial discomfort. On examination a 19.5 cm large epithelioid GIST of the stomach was diagnosed. The mass exhibited unfavorable prognostic features: mitotic index 18/50 high-power fields, large primary tumor size and male sex. Complete tumor resection with negative margins was achieved and metastases were not detected. The patient presented six months later with jaundice, asterixis and elevated liver enzymes. Computerized tomography showed multiple liver hypodense lesions representing metastases. Treatment with imatinib mesylate was of no avail and the patient died 3 days later as the result of hepatic failure. Massive liver metastases can, even though rarely, be responsible for fulminant hepatic failure. Clinical and radiological follow-up are crucial in patients with GIST even after surgical resection.


2019 ◽  
Vol 8 (2) ◽  
Author(s):  
Anna Garofalo ◽  
Paolo Petruzzelli ◽  
Michela Chiadò Fiorio Tin ◽  
Silvia Parisi ◽  
Giulia Garofalo ◽  
...  

Abstract Background Symptomatic myomas during pregnancy are a rare condition that could however turn into an emergency because of torsion, necrosis, growth and compression leading to acute abdomen, potentially threating for pregnancy. Surgeons are usually reluctant to perform myomectomy during pregnancy because of an increased uterine blood flow and volume can give rise to a potential risk for haemorrhagic complications, while uterine manipulation can determine adverse pregnancy outcome. However, in some rare cases surgery is compulsory. Case presentation Here, we described a case of a successful laparotomic myomectomy performed during pregnancy at 11 weeks of gestation when an acute abdomen occurred. Surgery was followed by regular obstetrics follow-up ended with a spontaneous vaginal delivery with no pregnancy complications. Conclusion Although few case reports are described in literature, other authors have performed a myomectomy during pregnancy, and fewer cases have had a subsequent vaginal delivery, so that nowadays there is no clinical evidence on which to base best practice. This case shows that vaginal delivery after a laparotomic myomectomy performed during pregnancy, in selected cases, can be considered as a feasible option.


2015 ◽  
Vol 81 (5) ◽  
pp. AB254-AB255
Author(s):  
Min Jae Yang ◽  
Sun Gyo Lim ◽  
Sung Jae Shin ◽  
Kee Myung Lee

2004 ◽  
Vol 7 (4) ◽  
pp. 380-384 ◽  
Author(s):  
Liliane Boccon-Gibod ◽  
Françoise Boman ◽  
Sabah Boudjemaa ◽  
Monique Fabre ◽  
Guy Leverger ◽  
...  

The nonfamilial Carney triad includes paraganglioma, gastrointestinal stromal tumor (GIST), and pulmonary chondroma. Some paraganglioma-GIST diads are familial and inherited in an apparent autosomal dominant manner. The familial paraganglioma-GIST syndrome differs from the Carney triad by the absence of female predilection and predominance of paragangliomas. We report the cases of a 12-year-old boy with a paraganglioma of the organ of Zuckerkandl, and his 13-year-old monozygotic twin with a gastric GIST. These two patients, to our knowledge, are the first to be reported as likely having the familial paraganglioma-GIST syndrome following its description by Carney and Stratakis (Am J Med Genet 2002;108:132–139) in 12 patients from five families. A lifetime follow-up and a periodic search for both tumors are indicated in these patients and their families.


2021 ◽  
Vol 5 (1) ◽  
pp. 49-53
Author(s):  
Aamir Ghazanfar ◽  
Afifa Asghar ◽  
Farrukh Zaman ◽  
Hassan Mumtaz ◽  
Shahzeb Habib ◽  
...  

A gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract. It is caused by the mutation in KIT and PDGFRα genes. It constitutes <1% of all gastrointestinal tumors. Duodenal GISTs constitute 4.5% of all GISTs. We report a 61-year-old lady, presented with generalized abdominal pain, vomiting, abdominal distension, and nausea for the last 3 years. Physical exam-ination showed a pallor and on abdominal examination, a large palpable mass was extending from the pelvis to the right upper quadrant of the abdomen. The CT scan showed a large heterogeneously echogenic mass in the abdomen and pelvis with no lymphadenopathy and distant metastasis in this region. Laparotomy showed a large globular mass extending from the pelvis to the right upper quadrant of the abdomen adherent to the wall of a third part of the duodenum. Complete surgical resection of tumor done with an intact capsule. Microscopic examination showed neoplastic spindle cells with tumor necrosis. An immunohistochemical study confirmed GIST.


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