A Case of Gastrointestinal Stromal Tumor of the Jejunum with Cystic Formation that Developed Small Bowel Volvulus

• Published in: The Kitakanto Medical Journal Vol. 68; no. 2; pp. 117 - 122
• Main Authors: Satoh, Taisuke, Iwanami, Kotaro, Kobayashi, Katsumi, Maemura, Michio
• Format: Journal Article
• Language: Japanese
• Published: The Kitakanto Medical Society 01.05.2018
• Subjects: Cystic formation; Small bowel volvulus; Small intestine GIST
• ISSN: 1343-2826; 1881-1191
• DOI: 10.2974/kmj.68.117

A 50-year-old man was transported to our emergency outpatient clinic presenting with lower abdominal pain and vomiting. Abdominal CT revealed a cystic tumor approximately 8cm in diameter in the left peritoneal cavity, and the “whirl sign” was seen in the small intestine loops and branches of the superior mesenteric artery. The diagnosis of cystic small intestine tumor with small intestine volvulus necessitated urgent laparotomy on the same day. Upon laparotomy, the small intestine was found to be twistwed 360°clockwise around the superior mesenteric artery. The intestine was not necrosed when strangulation was released. A cystic tumor, about 8 cm in diameter, was found in the jejunum 140 cm from the Treitz'ligament. He underwent partial resection of the jejunum, including the tumor. A solid tumor was found inside the cyst. The histopathological diagnosis was low-grade malignancy gastrointestinal stromal tumor (GIST) of the small intestine. Immunostaining showed the tumor was positive for c-kit and CD34. We report this rare case of cyst-forming GIST causing small-bowel volvulus, with a brief review of the literature.