Gastrointestinal stromal tumour (GIST)

Case contributed by Dr Hani Salam
  • There is a large, heterogenously enhancing soft tissue lesion, arising from the distal stomach (antral) /proximal doudenum and extending anteriorly, with central low attenuation in keeping with necrosis. The lesion is extering mass effect on the adjacent ascending and transverse colon and hepatic flexure as well as the gall bladder.
  • Few small retroperitoneal promineent lymph nodes seen, but no obvious lymph node enlargement in the mesentry. No pelvic or inguinal lymphadenomapthy.
  • The stomach is no distended and the oral contrast appears to be well passed through the small bowel, reaching large intestine.
  • Bilateral, variable sized renal cysts are seen.
  • No convincing peritoneal/omental deposits seen, no ascites.
  • insidental note of the left sided IVC, which ends at the left renal vein and crosses the aorta anteriorly to join the pre-hepatic IVC.
  • Portal, splenic and SMV are patent.
  • Liver, spleen, adrenals, and pancreas are unremarkable.

Interpretation: Based on the imaging features, a large gastrointestinal stromal tumour is high on the differential list. Gastric lymphoma thought less likely given the lack of associated lymph node enlargement. Incidental note of left sided IVC is made.

Case Discussion

Path proven case of GIST.

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Case information

rID: 13036
Published: 20th Feb 2011
Last edited: 11th Dec 2015
Inclusion in quiz mode: Included

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