Published online Jun 27, 2015. doi: 10.4240/wjgs.v7.i6.98
Peer-review started: December 7, 2014
First decision: February 7, 2015
Revised: April 16, 2015
Accepted: May 5, 2015
Article in press: May 6, 2015
Published online: June 27, 2015
Processing time: 299 Days and 12.6 Hours
Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumour of gastro-intestinal tract. Annual incidence of GIST in United States is approximately 3000-4000. Clinical presentation of GIST varies with location and size of tumour but GIST presenting with palpable abdominal mass is rare. We report a case of 38 years old male who presented with large abdominal lump. Computed tomography (CT) scan showed a large solid-cystic lesion encasing second part of duodenum and distal common bile duct. On CT differential diagnosis of Leiomyoma, Leiomyosarcoma and GIST were made. The diagnosis of GIST was confirmed by immune-histochemical study of the biopsy material. Patient underwent pancreaticodudenectomy. Post-operative course was uneventful. Patient was started on Imatinib therapy post-operatively. No recurrence noted at six months follow up.
Core tip: Gastrointestinal stromal tumours presenting with palpable abdominal mass are rare. Diagnosis is based upon histopathology and immunehistochemistry. Pre operatively patient should be evaluated with different modalities for diagnosis and resectability of tumour. Surgical resection with postoperative Imatinib chemotherapy helps to provide long term survival.