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2019, Number 1

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Revista Cubana de Cirugía 2019; 58 (1)

Gastrointestinal stromal tumor as a rare cause for hemoperitoneum

Mesa IO, Ferrer RH, Travieso PG, Gámez OH, González BY

Language: Spanish
References: 10
Page: 136-143
PDF size: 208.08 Kb.


ABSTRACT

Gastrointestinal stromal tumor is the most frequent mesenchymal tumor and is characterized by expression of a tyrosine kinase growth factor receptor, CD117 c-KIT/CD 117. It is different to the rest of mesenchymal tumors in that it does not express this protein. About 70-80% of these tumors are benign. The majority are located in the stomach and small intestine (more than 90%). Malignant gastrointestinal stromal tumors are usually large (over 5 cm in size), with a high mitotic index, and can metastasize to the liver and peritoneum. The treatment is surgical resection. We present a 65-year-old patient who came to the emergency room due to having fallen on her own feet and complaining of abdominal pain. As positive data to the physical examination, mucous and skin whitening and the emergency complement tests were analyzed. Ultrasound and CT scan reported free fluid in cavity with hemoglobin values at 6.4 g/L. The abdominal puncture showed red blood that did not clot. The exploratory laparotomy showed a hemoperitoneum and a large tumor in the anterior face of the gastric antrum, with a small one in the upper portion of the body; local resection with tumor-free borders was performed and the gastric borders were sutured. The result of the biopsy reported a spindle cell gastrointestinal stromal tumor with a low mitotic index, measuring 13 x 8 x 8 cm, with marked angiogenesis and areas of calcification.


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