title: Small intestinal gastrointestinal stromal tumor in a young adult woman: a case report and review of the literature.
abstract: BACKGROUND
  Gastrointestinal stromal tumor is the most common sarcoma of the gastrointestinal tract. We report a case of gastrointestinal stromal tumor in a small intestine, initially suspected for leiomyosarcoma given that gastrointestinal stromal tumors in young adult patients are limited due to their rarity.
  
  
  METHODS
  A 30-year-old Caucasian ethnic Albanian woman from Kosovo presented with abdominal pain, nausea and vomiting. Subsequently, the tumor was detected in her small intestine, as an infiltrating mass approximately 10 cm in diameter. The tumor was resected en bloc and duodenojejunal terminal-terminal anastomosis was performed. The tumor was a large, bulky, intramural mass, with fish-flesh to tan-brown appearance, as well as with foci of hemorrhage and necrosis. On histological examination the tumor showed transmural growth, deep infiltrative pattern and malignant feature, with mitotic count >5 per 50 high-power field, dense cellularity with plump spindle cells, and with eosinophilic cytoplasm within variably hyalinized and edematous stroma, skeinoid fibers (extracellular collagen globules) and foci of hemorrhage. In addition, the tumor was composed of areas with epithelioid morphology. The immunohistochemistry results showed high expression of proto-oncogene c-kit, CD117, CD34 and vimentin, whereas α-smooth muscle actin was focally positive. Desmin and S-100 protein were negative.
  
  
  CONCLUSIONS
  Gastrointestinal stromal tumor should be included in the differential diagnoses of intestinal mesenchymal tumors presenting as a single mass in young female adults. Given that gastrointestinal stromal tumors in young adults represent a more heterogeneous group than gastrointestinal stromal tumor in pediatric cases, more effort should be made to investigate its pathogenesis and potentially more specific treatment.
authors.affiliation: Institute of Pathology, Faculty of Medicine, University of Prishtina, Mother Theresa Street NN, 10 000 Prishtina, Kosovo. skerliu@hotmail.com.
authors.forename: Suzana
authors.initials: S
authors.lastname: Manxhuka-Kerliu
authors.forename: Vjollca
authors.initials: V
authors.lastname: Sahatciu-Meka
authors.forename: Irma
authors.initials: I
authors.lastname: Kerliu
authors.forename: Argjira
authors.initials: A
authors.lastname: Juniku-Shkololli
authors.forename: Lloreta
authors.initials: L
authors.lastname: Kerliu
authors.forename: Mevlyde
authors.initials: M
authors.lastname: Kastrati
authors.forename: Vesa
authors.initials: V
authors.lastname: Kotorri
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D004379:Duodenal Neoplasms / Q000175:diagnosis*; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis*; D006801:Humans; D007580:Jejunal Neoplasms / Q000175:diagnosis*; D007890:Leiomyosarcoma / Q000175:diagnosis*; D000090063:Proto-Oncogene Mas