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Metastatic gastrointestinal stromal tumour

Case contributed by Mohammad Taghi Niknejad
Diagnosis certain

Presentation

Severe abdominal pain and progressive distension.

Patient Data

Age: 25 years
Gender: Female

There is a 9/5 x 8.5 cm heterogeneously enhancing mass with large central cavitation between the liver, pancreas and stomach. The mass invades the left liver lobe, and local invasion to the pancreatic body is suspected. Multiple dilated collateral vessels are seen around the mass.

Multiple regional and aortocaval enlarged lymph nodes are evident. There are also multiple peritoneal tumoural depositis less than 30 mm in diameter. 

Additionally, multiple heterogeneously enhancing masses are seen in the liver inferring metastases.

A little amount abdominopelvic free fluid is present.

The spleen is enlarged. its cephalocaudal height measures 15.5 cm and it contains a few heteroenhancing masses less than 25 mm, suggesting metastases.

A few nodules are seen at both lungs less than 8 mm, inferring metastases.

A small amount pleural effusion is present bilaterally.

Case Discussion

The patient went on to have partial gastrectomy, left hepatectomy, omentectomy, and lymph node dissection, and histopathology evaluation confirmed gastrointestinal stromal tumour of the stomach.

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