Ulcerated gastrointestinal stromal tumor of the stomach
Gastric mass discovered at gastroscopy.
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Pathology report as follows:
A stomach was received measuring: small curvature 15 cm long, large curvature 24 cm long.
Located 4 cm from the proximal end and 9 cm from the distal end is a brown, ulcerated area with a raised rim measuring 4.5 x 4 x 2 cm. The rest of the mucosa is granulated.
On dissection of the fatty tissue, lymph nodes with a diameter of 0.4-2 cm were found.
Additionally, two anastomotic rings with a diameter of 1.5 cm and 2 cm.
Attached to the preparation is an omentum measuring 30 x 28 x 1.5 cm. Dissection showed no masses.
Total gastrectomy shows ulcerated gastric stromal tumor (GIST), measuring 4.5 cm in maximum diameter, positive for c-kit and CD34 markers with a mitotic rate of 5 mitoses/50 HPF.
Ki-67 stain shows a proliferative index of about 5%/50 HPFs.
No vascular involvement.
The surgical margins are free of tumor.
Both anastomotic rings and the omentum are free of tumor.
26 regional lymph nodes were examined, all of them free of tumor.
Based on tumor size and the mitotic rate, the tumor belongs to group 2 (size >2 <=5 cm and mitotic rate <=5/50 HPFs) with a very low risk (1.9%) for progressive disease/risk for metastasis.
- Markku Miettinen, Jerzy Lasota. Histopathology of gastrointestinal stromal tumor. (2011) Journal of Surgical Oncology. 104 (8): 865. doi:10.1002/jso.21945 - Pubmed
- Fortman B. Torricelli-Bernoulli sign in an ulcerating gastric leiomyosarcoma. (2013) AJR. American journal of roentgenology. 173 (1): 199-200. doi:10.2214/ajr.173.1.10397126 - Pubmed