Mahmoud Schauki, Salman Hosam, Salami Maissam
Department of General Surgery, Albassel Hospital, Tartous, Syrian Arab Republic.
Department of Histopathology, Albassel Hospital, Tartous, Syrian Arab Republic.
J Surg Case Rep. 2020 Jan 27;2020(1):rjz365. doi: 10.1093/jscr/rjz365. eCollection 2020 Jan.
Gastrointestinal stromal tumor is a rare neoplasm affecting gastrointestinal tract. Duodenal gastrointestinal stromal tumor originating from the fourth segment is considered an extremely rare disease. Surgical challenges arise when managing locally recurrent hemorrhagic duodenal gastrointestinal stromal tumor. A 58-year-old male presented with melena for the last 10 days. Thirty months previously, he had segmental resection of the fourth duodenal portion due to hemorrhagic gastrointestinal stromal tumor. No adjuvant imatinib therapy was administered (low risk for recurrence). The latest investigations showed actively bleeding tumor in the distal third portion of the duodenum, indicating a locally recurrent gastrointestinal stromal tumor. Uneventful emergent limited resection was performed. To the best of our knowledge, this is the first case report describing locally recurrent gastrointestinal stromal tumor in the distal duodenal portion. We will explain the therapeutic challenges and risk stratification and discuss gastrointestinal bleeding as a prognostic indicator for gastrointestinal stromal tumor recurrence.
胃肠道间质瘤是一种影响胃肠道的罕见肿瘤。起源于十二指肠第四段的十二指肠胃肠道间质瘤被认为是一种极其罕见的疾病。在处理局部复发性出血性十二指肠胃肠道间质瘤时会出现手术挑战。一名58岁男性在过去10天出现黑便。30个月前，他因出血性胃肠道间质瘤接受了十二指肠第四部分的节段性切除。未给予辅助伊马替尼治疗（复发风险低）。最新检查显示十二指肠远端三分之一处有活动性出血肿瘤，提示局部复发性胃肠道间质瘤。进行了顺利的急诊有限切除。据我们所知，这是第一例描述十二指肠远端局部复发性胃肠道间质瘤的病例报告。我们将解释治疗挑战和风险分层，并讨论胃肠道出血作为胃肠道间质瘤复发的预后指标。
