title: A large gastrointestinal stromal tumor of the duodenum treated by partial duodenectomy with Roux-en-Y duodenojejunostomy: a case report.
abstract: BACKGROUND
  Duodenal gastrointestinal stromal tumors are uncommon and a relatively small subset of gastrointestinal stromal tumors whose optimal surgical procedure has not been well defined. Because submucosal spread and local lymph node involvement are infrequent in gastrointestinal stromal tumors, wide margins with routine lymph node dissection may not be required. Various surgical procedures for duodenal gastrointestinal stromal tumor, pancreatoduodenectomy, pancreas-sparing duodenectomy, segmental duodenectomy, or local resection, have been described depending on the size and exact site of the lesion.
  
  
  METHODS
  We present the case of a 65-year-old African woman with a giant gastrointestinal stromal tumor involving the second and third portion of the duodenum successfully treated by partial duodenectomy with duodenojejunostomy. This surgical technique is ideal when a gastrointestinal stromal tumor does not involve the ampulla because it avoids a pancreatoduodenectomy, and has not been previously described for the management of this malignancy. Duodenal gastrointestinal stromal tumor should be suspected in any patient with a duodenal wall mass.
  
  
  CONCLUSIONS
  Gastrointestinal stromal tumors of the duodenum should be suspected in any patient with a duodenal wall mass. Extramural growth and central ulceration with or without bleeding should alert the endoscopist to the possibility of a duodenal gastrointestinal stromal tumor diagnosis.
authors.affiliation: Surgery Department, University Hospital Hassan II, Fez, Morocco. mouaqit.ouadii@gmail.com.
authors.forename: Ouadii
authors.initials: O
authors.lastname: Mouaqit
authors.forename: Leila
authors.initials: L
authors.lastname: Chbani
authors.forename: Khalid
authors.initials: K
authors.lastname: Maazaz
authors.forename: Afaf
authors.initials: A
authors.lastname: Amarti
authors.forename: Khalid
authors.initials: K
authors.lastname: Ait Taleb
authors.forename: Abdelmalek
authors.initials: A
authors.lastname: Oussaden