title: [A case of emergency resection of a giant gastrointestinal stromal tumor of the stomach associated with hemorrhagic shock].
abstract: We report a case of emergency resection of a giant gastrointestinal stromal tumor of the stomach associated with hemorrhagic shock. A 79-year-old woman was admitted to our hospital because of massive hematemesis. Laboratory analysis revealed a hemoglobin level of 6.5 g/dL. Abdominal computed tomography (CT) and upper gastrointestinal endoscopy revealed a submucosal tumor, 12 cm in diameter, in the fornix of the stomach. As a Dieulafoy-like lesion was present, we attempted coagulation hemostasis in the exposed blood vessels. Endoscopic hemostasis was not successful. The patient went into hemorrhagic shock. Emergency surgery was performed: total gastrectomy with distal pancreatosplenectomy. The resected specimen measured 10×12×7 cm and was hard. Immunohistologically, the tumor was positive for c-kit and CD34 and negative for alpha smooth muscle actin (αSMA), desmin, and S-100. Histological examination revealed that the patient had a high-risk gastrointestinal stromal tumor of the stomach with no nodal metastasis. The postoperative course was uneventful and the patient has remained alive without recurrence for 4 years.
authors.affiliation: Dept. of Surgery, Aomatsu Memorial Hospital.
authors.forename: Naoki
authors.initials: N
authors.lastname: Aomatsu
authors.forename: Masanori
authors.initials: M
authors.lastname: Nakamura
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Takeuchi
authors.forename: Takafumi
authors.initials: T
authors.lastname: Nishii
authors.forename: Kinshi
authors.initials: K
authors.lastname: Kosaka
authors.forename: Yasutake
authors.initials: Y
authors.lastname: Uchima
authors.forename: Hiromi
authors.initials: H
authors.lastname: Nakajima
authors.forename: Hajime
authors.initials: H
authors.lastname: Hanno
authors.forename: Osami
authors.initials: O
authors.lastname: Takeda
authors.forename: Minori
authors.initials: M
authors.lastname: Kawamura
authors.forename: Sigenori
authors.initials: S
authors.lastname: Takayanagi
authors.forename: Tomoomi
authors.initials: T
authors.lastname: Hirooka
authors.forename: Toshio
authors.initials: T
authors.lastname: Dozaiku
authors.forename: Takashi
authors.initials: T
authors.lastname: Hirooka
authors.forename: Keiho
authors.initials: K
authors.lastname: Aomatsu
mesh_terms: D000368:Aged; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000150:complications / Q000601:surgery*; D006801:Humans; D012771:Shock, Hemorrhagic / Q000209:etiology / Q000601:surgery*; D013274:Stomach Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome