Unusual sonographic appearance of a gastrointestinal stromal tumor presenting as a large multilocular cystic mass.
Cystic change is uncommon in gastrointestinal stromal tumor, (GISTs). This report describes 1 case in which a GIST presented as a large multilocular cystic mass. Sonography of the abdomen showed a huge cystic lesion with multiple septa in the left upper quadrant of the abdomen, compressing the left lobe of the liver. Esophagogastroscopy showed only a small submucosal tumor at the anterior wall of the mid portion of the gastric body. Endoscopic sonography revealed a hypoechoic mass, measuring 0.9 x 0.7 cm, arising from the fourth layer of the anterior wall of the mid portion of the gastric body. A huge cystic tumor, containing multiple septa and continuous with the small submucosal lesion, was found. Doppler signals were detected within the septa. Laparotomy revealed a huge exophytic cystic tumor arising from the stomach. Immunohistochemical analysis confirmed that the lesion was a GIST by detecting expression of the c-kit and CD34 proteins. GIST that has undergone cystic change must be differentiated from other cystic lesions to guide the treatment approach. Imatinib mesylate is a new therapeutic alternative for patients who have advanced GIST, but surgery remains the therapy of choice for resectable disease.
Chang
Chi-Yang
CY
Department of Internal Medicine, College of Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei 100, Taiwan.
Wang
Hsiu-Po
HP
Mao
Tasui-Lien
TL
Hu
Rey-Heng
RH
Yang
Pei-Ming
PM
Lai
Ming-Yang
MY
Lin
Jaw-Town
JT
D003560:Cysts / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D013274:Stomach Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D017154:Stromal Cells / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography