Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Mar 21, 2015; 21(11): 3388-3393
Published online Mar 21, 2015. doi: 10.3748/wjg.v21.i11.3388
Giant gastrointestinal stromal tumour of rare sarcomatoid epithelioid subtype: Case study and literature review
Gustaw Lech, Wojciech Korcz, Emilia Kowalczyk, Tomasz Guzel, Marcin Radoch, Ireneusz Wojciech Krasnodębski
Gustaw Lech, Tomasz Guzel, Ireneusz Wojciech Krasnodębski, Department of General, Gastroenterological and Oncological Surgery, Medical University of Warsaw, 02091 Warsaw, Poland
Wojciech Korcz, Emilia Kowalczyk, Marcin Radoch, Students’ Scientific Group at Department of General, Gastroenterological and Oncological Surgery, Medical University of Warsaw, 02091 Warsaw, Poland
Author contributions: Lech G wrote the manuscript and provided the original pictures; Korcz W wrote the manuscript; Kowalczyk E and Radoch M collected the clinical and radiological data; Guzel T and Krasnodębski IW reviewed the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Gustaw Lech, MD, PhD, Department of General, Gastroenterological and Oncological Surgery, Medical University of Warsaw, Banacha 1a, 02091 Warsaw, Poland. gustaw.lech@wum.edu.pl
Telephone: +48-22-5992482 Fax: +48-22-5992057
Received: July 26, 2014
Peer-review started: July 27, 2014
First decision: September 15, 2014
Revised: October 18, 2014
Accepted: December 16, 2014
Article in press: December 16, 2014
Published online: March 21, 2015
Processing time: 235 Days and 22.1 Hours
Abstract

Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract, but they represent less than 3% of all gastrointestinal tract malignancies. This is a detailed case study of a 52-year-old male patient treated for very uncommon histological subtype of gastric GIST with atypical clinical presentation, asymptomatic progress and late diagnosis. The resected tumour, giant in diameters, was confirmed to represent the most rare histopathologic subtype of GISTs - sarcomatoid epithelioid GIST. We report this case and review the literature with a special focus on pathomorphological evaluation, biological aggressiveness and prognostic factors. To our knowledge this is the first report of giant GIST of very uncommon sarcomatoid epithelioid subtype. It is concluded that clinicians should pay attention to the fact that initial diagnosis may be delayed due to mildly asymptomatic and non-specific clinical presentation. Asymptomatic tumours diagnosed at a late stage, which is often the case, can be large on presentation. Prognosis for patients diagnosed with GIST depend on tumour size, mitotic rate, histopathologic subtype and tumour location. That is why early diagnosis and R0 resection, which is usually feasible and safe even in giant gastric sarcomatoid epithelioid subtype of GISTs, are the key factors for further treatment and good prognosis.

Keywords: Gastrointestinal stromal tumour; Sarcomatoid epithelioid gastrointestinal stromal tumour; Gastric gastrointestinal stromal tumour; Gastrointestinal tract tumour

Core tip: This is a detailed case study of a 52-year-old male patient treated for very uncommon histological subtype of gastric gastrointestinal stromal tumour (GIST) with atypical clinical presentation, asymptomatic progress and late diagnosis. The resected tumour, giant in diameters, was confirmed to represent the most rare histopathologic subtype of GISTs - sarcomatoid epithelioid GIST. We report this case and review the literature with a special focus on pathomorphological evaluation, biological aggressiveness and prognostic factors. To our knowledge this is the first report of giant GIST of very uncommon sarcomatoid epithelioid subtype.