title: Gastrointestinal stromal tumor of the stomach with a giant abscess penetrating the gastric lumen.
abstract: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. In large GISTs, cystic degeneration, necrosis and focal hemorrhage that occur inside the tumor can result in gastrointestinal bleeding. We describe a case of a 74-year old male with GIST of the stomach accompanied with a giant abscess that penetrated the gastric lumen. The patient experienced undiagnosed fever for two months prior to hospitalization. Gastrointestinal endoscopy, X-ray series and computed tomography of the patient's abdomen revealed a gastric submucosal tumor in the fornix, with a fistula to the gastric lumen that was inundated with a great deal of pus. The mass was diagnosed as a GIST from biopsy specimens. The patient was treated by endoscopic drainage of the abscess and intravenous administration of antibiotics. Eventually, a partial gastrectomy was performed. He was also administered Imanitib mesylate as adjuvant therapy. He was followed up for 2 years and no metastasis or recurrence was recognized at the follow-up examinations. This is the first report of a patient with clearly diagnosed GIST with endoscopic evidence of an abscess penetrating into the gastric lumen.
authors.affiliation: Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan.
authors.forename: Taro
authors.initials: T
authors.lastname: Osada
authors.forename: Akihito
authors.initials: A
authors.lastname: Nagahara
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kodani
authors.forename: Akihiro
authors.initials: A
authors.lastname: Namihisa
authors.forename: Masato
authors.initials: M
authors.lastname: Kawabe
authors.forename: Takashi
authors.initials: T
authors.lastname: Yoshizawa
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Ohkusa
authors.forename: Sumio
authors.initials: S
authors.lastname: Watanabe
mesh_terms: D000038:Abscess / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004322:Drainage / Q000379:methods; D016145:Endoscopy, Digestive System; D046152:Gastrointestinal Stromal Tumors / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male; D013274:Stomach Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents