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Gastrointestinal stromal tumor

Case contributed by Mohammad Taghi Niknejad
Diagnosis certain

Presentation

Work up for abdominal pain and palpable mass on physical exam.

Patient Data

Age: 65 years
Gender: Male

A 50× 45 mm well-defined oval-shaped interloop soft tissue density enhancing mass is noted at the right side of the abdomen, anterior to the right kidney and seems to be exophytically originated from the small bowel loops.

A few small cysts are seen in the liver less than 10 mm.

A few non-enhanced simple cortical cysts are seen in both kidneys, with maximum diameters of 20 mm. In addition, an 18 mm parapelvic cyst is noted in the left kidney.

The prostate gland is enlarged.

Case Discussion

The patient underwent abdominal mass resection.

Histopathology:

Sections show ileal tissue with submucosal proliferation of neoplastic cells. Tumoral cells have spindle nuclei and scant eosinophilic cytoplasm arranged in short fascicles. Mitotic activity is present and 2 mitoses per 50 hpf are seen. Necrosis is not identified.

IHC result :CD117 and DOG1 are positive and S100 is negative.

Diagnosis: Gastrointestinal stromal tumor (GIST)

GIST is the most common mesenchymal tumor of the gastrointestinal tract, mostly found within the stomach and mid-distal small bowel. 

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