medigraphic.com
ISSN 2594-1518 (Electronic)
ISSN 1405-0099 (Print)

2015, Number 3-4

<< Back Next >>

Cir Gen 2015; 37 (3-4)

Gastrointestinal stromal tumor as a cause of gastrointestinal bleeding: presentation of a case

López-Valdés JC, Nava-Gutiérrez W, Astaburuaga-Gómez A, Pérez-Perales JE

Language: Spanish
References: 37
Page: 99-104
PDF size: 1053.91 Kb.


ABSTRACT

Introduction: Gastrointestinal stromal tumors are the most frequent mesenchymal neoplasms of the gastrointestinal tract, representing 0.1 to 3% of all gastrointestinal neoplasms. These tumors are mainly located in the stomach and small intestine (70 to 90%). Most of them are asymptomatic and are mostly incidental findings. However, there is a group of cases in which the main manifestation is gastrointestinal bleeding (hematemesis), which is often regarded as being ‘‘of unknown origin’’. Case description: A 55-year old male, with a medical history of type 2 diabetes and arterial hypertension, gastro-oesophageal reflux disease and gastritis. He was seen in the hospital with diffuse abdominal pain, postprandial fullness, and episodes of hematemesis. Laboratory findings showed, hemoglobin 9.3 g/dL, hematocrit 28.5%, platelets 324 × 103, white cells 11.5 × 103, glucose 183 mg/dL, creatinine 1.1 mg/dL, and albumin 4.4 g/dL. Contrasted CT and gastroscopy revealed a sub-epithelial mass with defined borders located on the greater curvature of the gastric body, 5-6 cm in diameter, and signs suggestive of ulceration. R0 resection was performed accompanied by immunomodulatory therapy with imatinib, bringing the total remission a year and a half after starting treatment.


REFERENCES

  1. Cano-Muñoz I, Avendaño-Avalos DB, Cuervo-Pérez L. Tumores del estroma gastrointestinal: revisión por imagen y correlación anatomopatológica. Presentación de cuatro casos. Ana Rad Mex. 2011; 1: 48-59.

  2. Rammohan A, Sathyanesan J, Rajendran K, et al. A gist of gastrointestinal stromal tumors: A review. World J Gastroinstest Oncol. 2013; 5: 102-112.

  3. Nemes C, Rogojan L, Surdea-Blaga T, et al. Gastrointestinal stromal tumor (GIST) associated with synchronous colonadenocarcinoma: A case report. J Gastrointestin Liver Dis. 2012; 21: 101-103.

  4. Acin-Gandara D, Pereira-Pérez F, Castaño-Pascual A, et al. Tumores estromales gastrointestinales: diagnóstico y tratamiento. Cir Ciruj. 2012; 80: 44-49.

  5. Shukla S, Singh SK, Pujani M. Multicentric malignant gastrointestinal stromal tumor. Saudi J Gastroenterol. 2009; 15: 45-48.

  6. Chapa-Azuela O, Ortiz-Higareda V, Etchegaray-Dondé A, et al. Tumores del estroma gastrointestinal (GIST) ampulares tratados con pancreaticoduodenectomía. Reporte de dos casos y revisión de la literatura. Rev Med Hosp Gen Mex. 2013; 76: 52-56.

  7. Pila-Pérez R, Rosales-Torres MD, Pila-Peláez R, et al. Tumor del estroma gastrointestinal (GIST): descripción de una rara observación. Rev Col Gastroenterol. 2009; 24: 403-407.

  8. Arroyo-Martínez L, Álvarez-Pertuz H, Acuña-Calvo J. Tumor gástrico estromal como causa de sangrado digestivo. Acta Med Costarric. 2006; 48: 131-134.

  9. Xie R. Gastrointestinal stromal tumors: short review on KIT/PDGFRA gene mutations and molecular therapy. J Gastroint Dig Syst. 2013; S12: 004.

  10. Fletcher CDM, Berman JJ, Corless C, et al. Diagnosis of gastrointestinal stromal tumors: A consensus approach. Int J Surg Pathol. 2002; 10: 81-89.

  11. Chi P, Chen Y, Zhang L, et al. ETV1 is a lineage survival factor that cooperates with KIT in gastrointestinal stromal tumours. Nature. 2010; 467: 849-855.

  12. Soto-GS, del Pozo-LM, Kuschel-HC, et al. Tumores estromales del tubo digestivo (GIST). A propósito de un caso clínico. Cuad Cir. 2003; 17: 37-42.

  13. García-Marín A, Matín-Gil J, Nofuentes-Riera C, et al. Hemorragia digestiva baja secundaria a tumor del estroma gastrointestinal rectal. Rev Gastroenterol Mex. 2010; 75: 332-334.

  14. Neira J, Morán C, Correa R, et al. Tumor del estroma gastrointestinal, en duodeno, como causa de hemorragia. Rev Med FCM-UCSG. 2011; 17: 274-279.

  15. Fernández JÁ, Sánchez-Cánovas ME, Parrilla P. Controversias en el tratamiento quirúrgico de los tumores del estroma gastrointestinal (GIST) primarios. Cir Esp. 2010; 88: 69-80.

  16. Bucher P, Villiger P, Egger JF, et al. Management of grastrointestinal stromal tumours: From diagnosis to treatment. Swiss Med Wkly. 2004; 134: 145-153.

  17. Novitsky YW, Kercher KW, Sing RF. Long-term outcomes of laparoscopic resection of gastric gastrointestinal stromal tumors. Ann Surg. 2006; 243: 738-747.

  18. Braghetto I, Parada FJ, Cardemil G. Tumores gastrointestinales estromales (GIST): Experiencia del Servicio de Cirugía de la Universidad de Chile entre 1999 y 2005. Rev Med Chile. 2007; 135: 551-557.

  19. Gómez G, Lombo M, Peñaloza F. Tumores estromales gástricos (GIST) malignos. Presentación de dos casos. Rev Colomb Gastroenterol. 2004; 19: 137-142.

  20. Oyanedel QR, O’Brien SA, Pizarro-GA, et al. Tumor estromal gastrointestinal (GIST): formas de presentación. Rev Chil Radiol. 2005; 11: 13-18.

  21. Bannura CG, Cornejo CV. Hemorragia digestiva baja recurrente secundaria a GIST de yeyuno. Rev Chil Cir. 2011; 63: 631-634.

  22. Bahena-Aponte JA, González-Contreras QH. Hemorragia de tubo digestivo alto como presentación inicial de tumor del estroma gastrointestinal a nivel de yeyuno proximal. Reporte de caso. Rev Invest Med Sur Mex. 2011; 18: 60-63.

  23. Shu ZB, Sun LB, Li JP, et al. Laparoscopic versus open resection of gastric gastrointestinal stromal tumors. Chin J Cancer Res. 2013; 25: 175-182.

  24. Daigle C, Meneghetti AT, Lam J, et al. Laparoscopic management of gastrointestinal stromal tumours: review at a Canadian centre. Can J Surg. 2012; 55: 105-109.

  25. DeMatteo RP, Heinrich MC, El-Rifai WM, et al. Clinical management of gastrointestinal stromal tumors: before and after STI-571. Human Pathol. 2002; 33: 466-477.

  26. Cappellani A, Piccolo G, Cardi F, et al. Giant gastrointestinal stromal tumor (GIST) of the stomach cause of high bowel obstruction: surgical management. World J Surg Oncol. 2013; 11: 172.

  27. Mouaqit O, Chbani L, Maazaz K, et al. A large gastrointestinal stromal tumor of the duodenum treated by partial duodenectomy with Roux-en-Y duodenojejunostomy: A case report. J MedCase Reports. 2013; 7: 184.

  28. Germano-Bassi D, Pérez-Adorno-da Silva F, de Oliveira-Sousa FM. GIST-induced upper gastrointestinal bleeding. Rev Assoc Med Bras. 2010; 56: 520-521.

  29. DeMatteo RP, Lewis JJ, Leung D, et al. Two hundred gastrointestinal stromal tumors: Recurrence patterns and prognostic factors for survival. Ann Surg. 2000; 231: 51-58.

  30. Parikh PM, Gupta S. Management of gastrointestinal stromal tumor: The imatinib era and beyond. Indian J Cancer. 2013; 50: 31-40.

  31. Biasco G, Velo D, Angriman I, et al. Gastrointestinal stromal tumors: Report of an audit and review of literature. Eur J Cancer Prev. 2009; 18: 106-116.

  32. Demetri GD, von Meheren M, Blanke CD, et al. Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med. 2002; 347: 472-480.

  33. Bracci R, Maccaroni E, Cascinu S. Transient sunitinib resistance in gastrointestinal stromal tumors. N Engl J Med. 2013; 368: 2042-2043.

  34. Lamba G, Ambrale S, Lee B, et al. Recent advances and novel agents for gastrointestinal stromal tumor (GIST). J Hematol Oncol. 2012; 5: 21.

  35. Demetri GD, Reichardt P, Kang Y, et al. Efficacy and safety of regorafenib for advanced gastrointestinal stromal tumours after failure of imatinib and sunitinib: An international, multicentre, prospective, randomised, placebo-controlled phase 3 trial (GRID). Lancet. 2013; 381: 295-302.

  36. Poveda A, Artigas V, Casado A, et al. Guía de práctica clínica en los tumores estromales gastrointestinales (GIST): actualización 2008. Cir Esp. 2008; 84: 1-21.

  37. Alberto S, Sánchez P, Oliveira M, et al. Tumores del estroma gastrointestinal. Estudio retrospectivo de 43 casos. Rev Esp Enferm Dig. 2008; 100: 696-700.




2020     |     www.medigraphic.com