A Huge Malignant Gastric Gastrointestinal Stromal Tumor in a Young Patient

다국어 초록 (Multilingual Abstract)

Malignant gastrointestinal stromal tumors (GISTs) are rare neoplasms originating from the gastrointestinal tract that rarely occur in patients below 40 years of age. To our knowledge, there have been no previous reports of satellite and metastatic nodules in GIST.
We present a case of a young patient with a huge malignant gastric GIST accompanied by spontaneous bleeding and satellite and metastatic nodules, successfully treated surgically, without preoperative chemotherapy administration. A 28-year-old man was admitted to Haeundae Paik Hospital with melena. A huge bulging gastric mass with ulceration and bleeding was observed on endoscopy.
A subepithelial lesion on the stomach body, abutting the pancreatic body and tail, with regional lymph node enlargement was confirmed by EUS and CT. Radical total gastrectomy was performed, the invasion surrounding the pancreatic tail and spleen were surgically dissected, and enlarged lymph nodes around the celiac trunk and the common hepatic artery were removed. The pathology results showed a malignant GIST with two satellite nodules and a metastatic tumor nodule at the left paracardial lymph node site. After complete resection of the malignant GIST, adjuvant chemotherapy with imatinib was initiated. Follow-up CT and endoscopy performed 6 months after surgery confirmed no recurrence of the disease.

참고문헌 (Reference)

1 Kosmidis CS, "Treatment of a gastrointestinal stromal tumor(GIST)Adherent to the spleen and the tail of the pancreas : a case report" 21 : e918278-, 2020

2 Tran T, "The epidemiology of malignant gastrointestinal stromal tumors : an analysis of 1, 458 cases from 1992 to 2000" 100 : 162-168, 2005

3 공성호 ; 양한광, "Surgical Treatment of Gastric Gastrointestinal Stromal Tumor" 대한위암학회 13 (13): 3-18, 2013

4 Agaimy A, "Lymph node metastasis in gastrointestinal stromal tumours(GIST)occurs preferentially in young patients < or = 40 years : an overview based on our case material and the literature" 394 : 375-381, 2009

5 Miettinen M, "Gastrointestinal stromal tumors--definition, clinical, histological, immunohistochemical, and molecular g endothelial features and differential diagnosis" 438 : 1-12, 2001

6 Sorour MA, "Gastrointestinal stromal tumors(GIST)related emergencies" 12 : 269-280, 2014

7 Miettinen M, "Gastrointestinal stromal tumors" 42 : 399-415, 2013

8 Canda AE, "Gastrointestinal stromal tumor of the stomach with lymph node metastasis" 6 : 97-, 2008

9 Pih GY, "Clinical outcomes of upper gastrointestinal bleeding in patients with gastric gastrointestinal stromal tumor" 34 : 696-706, 2020

10 구동회 ; 류민희 ; 김경미 ; 양한광 ; Akira Sawaki ; Seiichi Hirota ; Jie Zheng ; Bo Zhang ; Chin-Yuan Tzen ; Chun-Nan Yeh ; Toshirou Nishida ; Lin Shen ; Li-Tzong Chen ; 강윤구, "Asian Consensus Guidelines for the Diagnosis and Management of Gastrointestinal Stromal Tumor" 대한암학회 48 (48): 1155-1166, 2016