title: Gastro-intestinal stromal tumor (GIST) complicating a colonic interposition: a novel case report.
abstract: BACKGROUND
  Gastrointestinal stromal tumor (GIST) is a rare tumor comprising 0.1-0.3% of all gastrointestinal (GI) malignancies. Stomach followed by small intestine is the most common sites of involvement, implicated in 95% of the cases. We present a case of GIST complicating a colonic interposition. To the best of the author's knowledge, this is the first reported case of GIST complicating a colonic interposition.
  
  
  METHODS
  A 47 year old African American male presented to the emergency department with intermittent, severe chest pain. Past medical history was significant for alkali (NaOH) ingestion during 1980 for which esophageal resection and a colonic pull-through was performed. A CXR revealed a widened mediastinum and CT scan chest revealed showed a large (11.4 × 8.3 × 12.1 cm) vascular mediastinal mass. At endoscopy, a large, ulcerated, cratered and friable mass was found at 29 cm extending to 36 cm at which point the lower anastomosis of the colonic pull through was present. Multiple endoscopic biopsies were obtained which showed that the tumor was immunoreactive with CD117, CD34 and DOG1 while markers of carcinoma, melanoma and lymphoma were negative. In light of the pathology report, the immunohistochemistry and the CT scans, the tumor was classified as a stage 4 GIST of colonic interposition.
  
  
  CONCLUSIONS
  GIST can complicate unusual locations such as colonic interposition and should be kept in the differential diagnosis of such unusual presentations.
authors.forename: Maaz B
authors.initials: MB
authors.lastname: Badshah
authors.affiliation: Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA. harisriaz73@yahoo.com.
authors.forename: Haris
authors.initials: H
authors.lastname: Riaz
authors.forename: Mark A
authors.initials: MA
authors.lastname: Korsten
authors.forename: Atiya
authors.initials: A
authors.lastname: Dhala
authors.forename: Yeun-Hee A
authors.initials: YH
authors.lastname: Park
authors.forename: Maria
authors.initials: M
authors.lastname: Abadi
authors.forename: Mashood B
authors.initials: MB
authors.lastname: Badshah
mesh_terms: D003106:Colon / Q000002:abnormalities*; D046152:Gastrointestinal Stromal Tumors / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed