engleski

Laparoscopic wedge resection of small GIST mimicking gastric erosion causing upper GI bleeding

INTRODUCTION: Gastrointestinal stromal tumors (GISTs), the most common nonepithelial neoplasms of the gastrointestinal (GI) tract, occur most commonly in the stomach. Although usually asymptomatic, GISTs may present with pain or bleeding. Surgery is the mainstay for resectable nonmetastatic GISTs. Laparoscopic techniques are the last frontier in surgical treatment of GISTs which provide a minimally invasive approach to stomach and enable organ preservation. CASE REPORT: We reported a case of 60- year-old woman who presented with upper GI bleeding and pain in upper abdomen. Preoperative endoscopy revealed hyperemic antral mucosa and one bigger erosion on the border of corpus and antrum. On repeated endoscopy, it was more clearly that erosion was on small polyp. Multiple forceps biopsies were taken form the polyp in 2 consecutive endoscopies, but malignancy wasn&#8217; t found. Endoscopic ultrasound (EUS) revealed small lesion size 11x9 mm in muscularis propria and no visible lymph nodes in the region. EUS guided FNA was performed and material was obtained for cytological analysis. Cytological examination showed immunoreactivity for CD 34, vimentin, desmin suggesting GIST The tumor was resected by laparoscopic surgery, because any distant metastasis by computed tomography (MSCT) did not detect. Postoperative histological examination confirmed GIST. The surgical procedure was without complication and the patient was discharged 4 days after operation. CONCLUSION: Laparoscopic wedge resection is feasible treatment option for GIST of the stomach if the lesion is < 5 cm in diameter. In such cases, careful follow-up is needed to detect liver metastasis and local recurrence.

GIST; laparoscopic resection

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