A Gastrointestinal Stromal Tumor of the Small Intestine with Dedifferentiation

• Published in: The Japanese Journal of Gastroenterological Surgery Vol. 49; no. 8; pp. 780 - 787
• Main Authors: Yamada, Mihoko, Ogura, Yutaka, Shirai, Kazuhisa, Nishigaki, Eiji, Miyata, Kazushi, Hirose, Tomoaki, Yokoi, Takio, Katayama, Makoto
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Society of Gastroenterological Surgery 01.08.2016
• Subjects: dedifferentiation; gastrointestinal stromal tumor (GIST); small intestinal tumor
• ISSN: 0386-9768; 1348-9372
• DOI: 10.5833/jjgs.2015.0079

Gastrointestinal stromal tumor (GIST) usually has a relatively monotonous histological appearance and partial dedifferentiation is rare. We report a case of GIST of the small intestine with dedifferentiation. A 59-year-old man presented to a local clinic with left-sided abdominal pain and anorexia. A mass was detected in the left side of the abdomen and he was admitted to our hospital. Abdominal CT showed a 12-cm mass containing fluid and a niveau. Small bowel enteroclysis showed that gastrografin flowed into the mass. 3D CT-angiography demonstrated that the mass was supplied by the left gastroepiploic artery, superior mesenteric artery, and inferior mesenteric artery. At operation, the tumor showed extraluminal growth and arose from the jejunum. The patient underwent jejunectomy, omentectomy, descending colectomy, and resection of the left Gerota fascia. The tumor was completely resected. Histopathological examination identified GIST of the small intestine with partial dedifferentiation.