title: A case of a duodenal gastrointestinal stromal tumor diagnosed with the aid of diffusion-weighted magnetic resonance imaging.
abstract: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumor of gastrointestinal tract, and bleeding is among the primary symptoms. If the tumor is located in the small intestine, diagnosis might be difficult because of its inaccessibility by endoscope. This report presents a case of duodenal GIST diagnosed with the aid of diffusion-weighted (DW) magnetic resonance imaging (MRI). A 66-year-old male was admitted to the hospital because of shortness of breath and melena. The patient demonstrated marked anemia. Esophagogastroduodenoscopy and colonoscopy revealed no involvement of the mucosa of the gastrointestinal tract in regard to the observed bleeding. Thereafter, computed tomography was done and showed a tumorous lesion 4.2 cm in diameter located around the ligament of Treitz. The area showed significant high intensity by DW-MRI, strongly suggesting malignant character. Examination with a long endoscope demonstrated a large submucosal tumor with wide ulceration located at the third portion of the duodenum. The biopsy sample contained spindle-shaped cells that were positive for CD34 and c-kit on histochemistry, and the tumor was diagnosed as GIST. The patient underwent surgery and survived for 16 months without any recurrence.
authors.affiliation: Department of Gastroenterology, Tokyo Teishin Hospital, 2-14-23 Fujimi, Chiyoda-ku, Tokyo, 102-8798, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Matsui
authors.affiliation: Department of Gastroenterology, Tokyo Teishin Hospital, 2-14-23 Fujimi, Chiyoda-ku, Tokyo, 102-8798, Japan. mitsuih-tky@umin.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Mitsui
authors.affiliation: Department of Gastroenterology, Tokyo Teishin Hospital, 2-14-23 Fujimi, Chiyoda-ku, Tokyo, 102-8798, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Sekigawa
authors.affiliation: Department of Gastroenterology, Tokyo Teishin Hospital, 2-14-23 Fujimi, Chiyoda-ku, Tokyo, 102-8798, Japan.
authors.forename: Katsuya
authors.initials: K
authors.lastname: Kobayashi
authors.affiliation: Department of Gastroenterology, Tokyo Teishin Hospital, 2-14-23 Fujimi, Chiyoda-ku, Tokyo, 102-8798, Japan.
authors.forename: Masao
authors.initials: M
authors.lastname: Okubo
authors.affiliation: Department of Gastroenterology, Tokyo Teishin Hospital, 2-14-23 Fujimi, Chiyoda-ku, Tokyo, 102-8798, Japan.
authors.forename: Eriko
authors.initials: E
authors.lastname: So
authors.affiliation: Department of Gastroenterology, Tokyo Teishin Hospital, 2-14-23 Fujimi, Chiyoda-ku, Tokyo, 102-8798, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Nakachi
authors.affiliation: Department of Gastroenterology, Tokyo Teishin Hospital, 2-14-23 Fujimi, Chiyoda-ku, Tokyo, 102-8798, Japan.
authors.forename: Naoaki
authors.initials: N
authors.lastname: Hashimoto
authors.affiliation: Endoscope Center, Tokyo Teishin Hospital, 2-14-23 Fujimi, Chiyoda-ku, Tokyo, 102-8798, Japan.
authors.forename: Hajime
authors.initials: H
authors.lastname: Yamaguchi
authors.affiliation: Department of Surgery, Tokyo Teishin Hospital, 2-14-23 Fujimi, Chiyoda-ku, Tokyo, 102-8798, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Ishikawa
authors.affiliation: Department of Surgery, Tokyo Teishin Hospital, 2-14-23 Fujimi, Chiyoda-ku, Tokyo, 102-8798, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Okuda
authors.affiliation: Department of Surgery, Tokyo Teishin Hospital, 2-14-23 Fujimi, Chiyoda-ku, Tokyo, 102-8798, Japan.
authors.forename: Kanetoshi
authors.initials: K
authors.lastname: Sato
authors.affiliation: Department of Surgery, Tokyo Teishin Hospital, 2-14-23 Fujimi, Chiyoda-ku, Tokyo, 102-8798, Japan.
authors.forename: Hiroo
authors.initials: H
authors.lastname: Terashima
authors.affiliation: Department of Pathology, Tokyo Teishin Hospital, 2-14-23 Fujimi, Chiyoda-ku, Tokyo, 102-8798, Japan.
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Kishida
authors.affiliation: Department of Pathology, Tokyo Teishin Hospital, 2-14-23 Fujimi, Chiyoda-ku, Tokyo, 102-8798, Japan.
authors.forename: Kouichi
authors.initials: K
authors.lastname: Tamura
authors.affiliation: Department of Radiology, Tokyo Teishin Hospital, 2-14-23 Fujimi, Chiyoda-ku, Tokyo, 102-8798, Japan.
authors.forename: Takeo
authors.initials: T
authors.lastname: Suzuki
keywords: Diffusion-weighted magnetic resonance imaging; Duodenum; Gastrointestinal stromal tumor; Submucosal tumor