title: Spontaneous rupture of a giant gastrointestinal stromal tumor of the jejunum: a case report and literature review.
abstract: A few cases of a gastrointestinal stromal tumor (GIST) of the small intestine presenting as rupture have been reported in the medical literature. We report an unusual case of a large GIST of the jejunum that presented as a spontaneous rupture. A 70-year-old man was referred to our hospital because of fever and abdominal pain. An abdominal enhanced computed tomography (CT) scan detected a 10-cm tumor with heterogeneous staining, suggesting necrosis or abscess inside the tumor. The patient was treated with antibiotics but inflammation persisted and an operation was performed. Intraoperative findings showed an outgrowing 10-cm mass in the jejunum near Treitz's ligament. The tumor had ruptured with peritoneal metastasis. The solid parenchyma contained a focal area of necrosis within and the small ulcer located in the wall of the jejunum presented a communication with the large tumor cavity. H&E staining showed spindle-shaped cell proliferation, and immunohistochemical staining showed results positive for c-kit and CD34. The patient received a diagnosis of a GIST (high-risk group) of the jejunum and was treated with imatinib mesylate. The patient has remained in good health without recurrence or metastasis one year after the surgical procedure.
authors.affiliation: Department of Surgery, Matsumoto City Hospital, 4417-180 Hata, Matsumoto, Nagano 390-1401, Japan. 96084sm@jichi.ac.jp.
authors.forename: Shun-ichi
authors.initials: S
authors.lastname: Misawa
authors.forename: Misuzu
authors.initials: M
authors.lastname: Takeda
authors.forename: Hiroto
authors.initials: H
authors.lastname: Sakamoto
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Kirii
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Ota
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takagi
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001549:Benzamides / Q000627:therapeutic use; D003131:Combined Modality Therapy; D046152:Gastrointestinal Stromal Tumors / Q000150:complications* / Q000473:pathology / Q000628:therapy; D006801:Humans; D000068877:Imatinib Mesylate; D007580:Jejunal Neoplasms / Q000150:complications* / Q000473:pathology / Q000628:therapy; D008297:Male; D010534:Peritoneal Neoplasms / Q000150:complications* / Q000556:secondary / Q000628:therapy; D010879:Piperazines / Q000627:therapeutic use; D011379:Prognosis; D011743:Pyrimidines / Q000627:therapeutic use; D012422:Rupture, Spontaneous / Q000209:etiology* / Q000628:therapy; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate