title: A Pancreatic Head Tumor Arising as a Duodenal GIST: A Case Report and Review of the Literature.
abstract: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors of the gastrointestinal tract that originate from the intestinal cells of Cajal (ICC) (Fletcher et al., 2002). Only a few cases have been described with extragastrointestinal stromal tumors (Kim et al., 2012; Soufi et al., 2013; Meng et al., 2011). They are often diagnosed as a pancreatic head tumor as they are very difficult to relate to the duodenum with CT, MRI, or ultrasound. We present a case of a sixty-four-year-old woman who presented with abdominal pain and cardialgia for a follow-up examination after breast cancer surgery. On laparotomy there was a 3 × 5 cm hypervascular mass arising from the pancreatic head with macroscopically no attachment to the duodenum. The patient underwent pancreatoduodenectomy (PD) modified after Traverso-Longmire, histopathology proved a duodenal GIST. This case proves that duodenal GISTs can grow invasively into the pancreas and appear as solid pancreas head tumor; therefore, these tumors should be included into differential diagnosis.
authors.affiliation: Klinik für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie, Klinikum Frankfurt Höchst, Gotenstraße 6-8, 65929 Frankfurt am Main, Germany.
authors.forename: Fabian
authors.initials: F
authors.lastname: Bormann
authors.affiliation: Klinik für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie, Klinikum Frankfurt Höchst, Gotenstraße 6-8, 65929 Frankfurt am Main, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Wild
authors.affiliation: Klinik für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie, Klinikum Frankfurt Höchst, Gotenstraße 6-8, 65929 Frankfurt am Main, Germany.
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Aksoy
authors.affiliation: Klinik für Radiologie, Neuroradiologie und Nuklearmedizin, Klinikum Frankfurt Höchst, Gotenstraße 6-8, 65929 Frankfurt am Main, Germany.
authors.forename: Pius
authors.initials: P
authors.lastname: Dörr
authors.affiliation: Institut für Pathologie, Klinikum Frankfurt Höchst, Gotenstraße 6-8, 65929 Frankfurt am Main, Germany.
authors.forename: Sanja
authors.initials: S
authors.lastname: Schmeck
authors.affiliation: Klinik für Allgemein-, Viszeral-, Thorax- und Gefäßchirurgie, Klinikum Frankfurt Höchst, Gotenstraße 6-8, 65929 Frankfurt am Main, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Schwarzbach