[Gastrointestinal stromal tumor (GIST): a rare case of severe gastric haemorrhage].
BACKGROUND
A rare case of gastrointestinal stromal tumor (GIST) provoking a severe gastric bleeding is reported. Case report and results. The Authors report on the case of a 53-year-old male patient who presented with hematemesis, melena and severe acute anemia (Hb: 6 g/dl). EGDS disclosed a protruding lesion centrally ulcerated, of 7 cm in size, localized in the upper half of gastric corpus. Multiple endoscopic biopsies were negative for neoplastic changes. Because of further gastric bleeding, a total gastrectomy with "Roux-en-Y" reconstruction was performed in urgency GIST of smooth muscle was diagnosed by histological and immunohistochemical postoperative examination.


CONCLUSIONS
Gist are neoplasms arising from connective tissue elements of gastrointestinal wall, which represent about 2% of GI-tract malignant tumor. Tumor size of 5 cm or greater, elevated mitotic count, lack of histological differentiation are significantly associated with a shorter recurrence-free survival. GIST-s are rarely cause of an inarrestable gastric bleeding. For gastroenterological surgeons it is critical to select the most suitable surgical procedure. In our case, 9 months after gastrectomy the patient is well, in spite the severe clinical background and the malignancy degree.


CONCLUSIONS
The GIST-s have to be taken into account in the differential diagnosis of GI-tract tumors if endoscopic biopsies are negative for malignancy. In our opinion, total or partial gastrectomy fro gastric should be preferred. Moreover, a close follow up is recommended.
Unità Operativa di Chirurgia Generale, Ospedale Civile di Atessa, ASL Lanciano-Vasto.
S
S
Cericola
G
G
Cericola
A
A
Rotolo
R
R
Fulgente
A
A
Merla Vitalone
D000713:Anastomosis, Roux-en-Y; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D005743:Gastrectomy / Q000379:methods; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D005770:Gastrointestinal Neoplasms / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D017154:Stromal Cells / Q000473:pathology*