Gastric stromal tumor

Case contributed by Dr Vesela Slaveykova Mitova

Presentation

Melena (upper gastrointestinal bleeding) and months of fatigue

Patient Data

Age: 80 years
Gender: Male
ct

A well-defined tumor growth arising from the anterior gastric wall. It is attached to the small curvature and does not invade the surrounding tissues. It is with heterogenous structure and moderate mainly peripheral contrast enhancement. 

Multiple pulmonary nodules with most probable hematogenous metastatic origin.

The findings is mainly suggestive of gastric mesenchymal tumor.

Surgical specimen

Photo

A surgical specimen resected from the anterior gastric wall which seems to arise from the muscularis propria.

Case Discussion

Gastroscopy report: slide prominence at the anterior gastric wall with superficial ulcerations. 

CT and surgical resection were later performed.

 

Postoperative pathology report: 

Macroscopic: tumor with superficial ulcerations; microscopic morphologic type- epithelioid cells, low mitotic count- >5/50 HPF

Immunohistochemistry: tumor cells show positive (+) c-kit and negative (-) S100, CD34, SMA reaction.

The report concluded: gastric stromal tumor.

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