Chen JH, Huang Y. High-frame-rate contrast-enhanced ultrasound findings of liver metastasis of duodenal gastrointestinal stromal tumor: A case report and literature review. World J Clin Cases 2022; 10(17): 5899-5909 [PMID: PMC9258392 DOI: 10.12998/wjcc.v10.i17.5899]
Corresponding Author of This Article
Ying Huang, MD, PhD, Chief Doctor, Department of Ultrasound, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China. huangying712@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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/
World J Clin Cases. Jun 16, 2022; 10(17): 5899-5909 Published online Jun 16, 2022. doi: 10.12998/wjcc.v10.i17.5899
High-frame-rate contrast-enhanced ultrasound findings of liver metastasis of duodenal gastrointestinal stromal tumor: A case report and literature review
Jia-Hui Chen, Ying Huang
Jia-Hui Chen, Ying Huang, Department of Ultrasound, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning Province, China
Author contributions: Chen JH and Huang Y reviewed the literature and contributed to manuscript drafting; Huang Y performed the high frame rate contrast-enhanced ultrasound and biopsy operation; all authors issued final approval for the version to be submitted.
Supported bythe Guide Project for Key Research and Development Foundation of Liaoning Province, No. 2019JH8/10300008; the 345 Talent Project; and the Liaoning Baiqianwan Talents Program.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ying Huang, MD, PhD, Chief Doctor, Department of Ultrasound, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang 110004, Liaoning Province, China. huangying712@163.com
Received: January 22, 2022 Peer-review started: January 22, 2022 First decision: February 24, 2022 Revised: March 3, 2022 Accepted: April 4, 2022 Article in press: April 4, 2022 Published online: June 16, 2022 Processing time: 137 Days and 20.2 Hours
Abstract
BACKGROUND
Liver metastasis of duodenal gastrointestinal stromal tumor (GIST) is rare. Most reports mainly focus on its treatment and approaches to surgical resection, while details on its contrast-enhanced ultrasound (CEUS) findings are lacking. The diagnosis and imaging modalities for this condition remain challenging.
CASE SUMMARY
A 53-year-old Chinese man presented with mild signs and symptoms of the digestive tract. He underwent routine examinations after GIST surgery. Magnetic resonance imaging showed a 2.3 cm hepatic space-occupying lesion. All the laboratory test results were within normal limits. For further diagnostic confirmation, we conducted high frame rate CEUS (H-CEUS) and found a malignant perfusion pattern. Heterogeneous concentric hyper-enhancement, earlier wash-in than the liver parenchyma, and two irregular vessel columns could be observed at the periphery of the lesion during the arterial phase. Ultrasound-guided puncture biopsy was used to confirm the diagnosis of the lesion as liver metastasis of duodenal GIST. Imatinib was prescribed after biopsy, and the patient’s clinical course was monitored.
CONCLUSION
H-CEUS is useful for detecting microcirculation differences, wash-in patterns, and vascular morphogenesis and diagnosing liver metastasis of duodenal GIST.
Core Tip: Gastrointestinal stromal tumors (GISTs) are the most common types of gastrointestinal mesenchymal tumors. The liver is considered the most common organ target of metastasis; however, liver metastasis of duodenal GIST is extremely rare. We describe a new imaging modality, high frame rate contrast-enhanced ultrasound, for detecting microcirculation differences in the lesion, wash-in patterns during the early arterial phase, and vascular morphogenesis due to its high frame rate, during which liver metastasis of duodenal GIST can be diagnosed accurately. No complications were observed in our patient. We recommend this new technology for the diagnosis of liver metastasis of duodenal GIST.
