title: Small periampullary duodenal gastrointestinal stromal tumor treated by local excision: report of a case.
abstract: Gastrointestinal stromal tumors (GIST) are mainly located in the stomach and the small bowel, with the duodenum accounting for about 4%. We report the case of a 66-year-old woman with a periampullary GIST of the duodenum that was treated by local excision and direct duodenal wall defect repair. Since no definitive clinical criteria have been established to differentiate malignant from benign mesenchymal tumors, preoperative cytology was not available and surgical removal of the 3.5 cm tumor was feasible, the patient was treated conservatively. The morbidity and mortality rates of the more radical and invasive duodenopancreatectomy, in particular when dealing with a soft pancreatic stump with a narrow pancreatic duct, are, in our opinion, too high for a potentially benign disease when the more conservative procedure is feasible. Four years after surgery the patient is doing well and control CT scan showed the absence of local recurrence.
authors.affiliation: Department of Surgery Pietro Valdoni, Second Faculty of Medicine, University of Rome, La Sapienza, Italy. marco.cavallini@uniroma1.it
authors.forename: Marco
authors.initials: M
authors.lastname: Cavallini
authors.forename: Andrea
authors.initials: A
authors.lastname: Cecera
authors.forename: Antonio
authors.initials: A
authors.lastname: Ciardi
authors.forename: Salvatore
authors.initials: S
authors.lastname: Caterino
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Ziparo
mesh_terms: D000368:Aged; D014670:Ampulla of Vater / Q000473:pathology; D013505:Digestive System Surgical Procedures / Q000379:methods*; D004379:Duodenal Neoplasms / Q000473:pathology / Q000601:surgery*; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology / Q000601:surgery*; D006801:Humans; D016896:Treatment Outcome