Acute Abdomen Syndrome Caused by a Perforated Gastrointestinal Stromal Tumor - A Case Report

Authors

  • Taner Kivilcim Department of General Surgery, Sakarya University Research and Educational Hospital, Turkey
  • Fatih Altintoprak Department of General Surgery, Sakarya University Faculty of Medicine, Turkey
  • Feyyaz Onuray Department of General Surgery, Sakarya University Research and Educational Hospital, Turkey
  • Serbulent Gokhan Beyaz Department of Anesthesiology, Sakarya University Faculty of Medicine, Turkey
  • Muzaffer Yildirim Department of Pathology, Sakarya University Faculty of Medicine, Turkey
  • Osman Nuri Dilek Department of General Surgery, Sakarya University Faculty of Medicine, Turkey

DOI:

https://doi.org/10.6000/1929-2279.2013.02.01.2

Keywords:

Stromal tumor, Perforation, Acute abdomen syndrome.

Abstract

 Gastrointestinal stromal tumors (GIST) are frequently observed in the stomach and intestines. Although they may be presented with various symptoms depending on their location and diameter, acute abdomen syndrome is a rare presentation form for GIST. A 54-year-old male patient was evaluated with the complaint of sudden onset abdominal pain at the urology clinic. In examination; fever (38.5 ̊C), abdominal distension and peritoneum irritation signs were detected. A mass that contained localized necrotic areas thought to have mesentery origins and intraabdominal free-fluid were detected on abdominal computed tomography. The patient was operated with the diagnosis of acute abdomen syndome. In operation; extensive intestinal content in the abdomen, a perforated tumoral mass which was 7x5 cm in diameter, and anti-mesenterically localized at the ileum segment were detected. Segmental ileum resection-end ileostomy operation was performed, and the patient was discharged as uneventful on post-operative tenth day. As a result of a histopathological analysis, a GIST (<5/50 mitotic growth) was detected. By means of this finding, we want to remind that GISTs may be presented with acute abdomen symptoms due to perforation, though rarely.

References

Kindblom LG, Remotti HE, Aldenborg F, Meis-Kindblom JM. Gastrointestinal pacemaker cell tumor (GIPACT): gastrointestinal stromal tumors show phenotypic characteristics of the interstitial cells of Cajal. Am J Pathol 1998; 152(5): 1259-69.

Blanchard DK, Budde JM, Hatch GF 3rd, Wertheimer-Hatch L, Hatch KF, Davis GB, et al. Tumors of the small intestine. World J Surg 2000; 24(4): 421-29. http://dx.doi.org/10.1007/s002689910067

Bilimoria KY, Bentrem DJ, Wayne JD, Ko CY, Bennett CL, Talamonti MS. Small bowel cancer in the United States: changes in epidemiology, treatment, and survival over the last 20 years. Ann Surg 2009; 249(1): 63-71. http://dx.doi.org/10.1097/SLA.0b013e31818e4641

Van der Zwan SM, DeMatteo RP. Gastrointestinal stromal tumor: 5 years later. Cancer 2005; 104(9): 1781-88. http://dx.doi.org/10.1002/cncr.21419

Badger SA, Yousaf M, Campbell WJ. A case of a gastrointestinal stromal tumour presenting as acute abdomen. Ir J Med Sci 2005; 174(3): 84-5. http://dx.doi.org/10.1007/BF03169154

Efremidou EI, Liratzopoulos N, Papageorgiou MS, Romanidis K. Perforated GIST of the small intestine as a rare cause of acute abdomen: Surgical treatment and adjuvant therapy. Case report. J Gastrointestin Liver Dis 2006; 15(3): 297-9.

Bucher P, Villiger P, Egger JF, Buhler LH, Morel P. Management of gastrointestinal stromal tumors: from diagnosis to treatment. Swiss Med Wkly 2004; 134(11-12): 145-53.

Chourmouzi D, Sinakos E, Papalavrentios L, Akriviadis E, Drevelegas A. Gastrointestinal stromal tumors: a pictorial review. J Gastrointestin Liver Dis 2009; 18(3): 379-83.

Dupart J, Zhang W, Trent JC. Gastrointestinal stromal tumor and its targeted therapeutics. Chin J Cancer 2011; 30(5): 303-14. http://dx.doi.org/10.5732/cjc.011.10062

Valadao M, Linhares E. The role of the surgeon in the management of GIST. Rev Col Bras Cir 2009; 36(3): 261-65.

Joensuu H, Roberts PJ, Sarlomo-Rikala M, Andersson LC, Tervahartiala P, Tuveson D, et al. Effect of the tyrosine kinase inhibitor STI571 in a patient with a metastatic gastrointestinal stromal tumor. N Eng J Med 2001; 344(14): 1052-56. http://dx.doi.org/10.1056/NEJM200104053441404

Blanke CD, Rankin C, Demetri GD, Ryan CW, von Mehren M, Benjamin RS, et al. Phase III randomized, intergroup trial assessing imatinib mesylate at two dose levels in patients with unresectable or metastatic gastrointestinal stromal tumors expressing the kit receptor tyrosine kinase: S0033. J Clin Oncol 2008; 26(4): 626-32. http://dx.doi.org/10.1200/JCO.2007.13.4452

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Published

2013-01-14

How to Cite

Taner Kivilcim, Fatih Altintoprak, Feyyaz Onuray, Serbulent Gokhan Beyaz, Muzaffer Yildirim, & Osman Nuri Dilek. (2013). Acute Abdomen Syndrome Caused by a Perforated Gastrointestinal Stromal Tumor - A Case Report . Journal of Cancer Research Updates, 2(1),  10–13. https://doi.org/10.6000/1929-2279.2013.02.01.2

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