Gastrointestinal Stromal Tumor of the Rectum: A case report (original) (raw)

Gastrointestinal stromal tumor of rectum

Journal of Surgical Sciences

Although gastrointestinal stromal tumors (GISTs) frequently occur in the gastrointestinal tract, they are relatively rare in the rectum. Biopsy of the lesion and immunohistochemistry (IHC) confirm the diagnosis. Complete surgical resection is the principal curative procedure. In combination with surgery, immunotherapy with Imatinib shows cure in intermediate risk and improvement in high risk rectal GIST. We report a case of a 45-yearold female who presented with constipation and generalized weakness, ultimately diagnosed to have rectal GIST. Journal of Surgical Sciences (2015) Vol. 19 (2) : 85-88

Gastrointestinal stromal tumour of the rectum: Report of a case and review of literature

World Journal of Gastroenterology, 2008

Gastrointestinal stromal tumour (GIST) is a rare tumour of the gastrointestinal tract which does not generally originate in the rectum. The authors describe a case of a 70-year-old man who underwent an anterior resection of the rectum for a low-risk GIST. The patient was not given adjuvant chemotherapy with imatinib and is still disease-free 30 mo after surgery. The authors conclude that although rectal GIST is extremely uncommon, it should be included in differential diagnosis when a tumour in the rectum is detected. Biopsy of the tumour is essential, since this makes it possible to reach a sure preoperative diagnosis based on the immunohistological features of the CD117 and CD34. Although complete surgical resection with negative tumour margins is the principal curative procedure for primary and nonmetastatic tumours, further studies are still needed for the determination of the most effective treatment strategy for patients with rectal GIST.

Malignant Gastrointestinal Stromal Tumor of Rectum: A Case Report and Review of Literature

The Surgery Journal, 2022

Gastrointestinal stromal tumors (GISTs) are rare tumors of the gastrointestinal tract accounting for less than 1% of all gut tumors. GISTs occurring in the rectum are extremely rare and these usually present at an advanced stage compared with other sites.We report a case of a middle-aged female who presented with features of anemia and subacute obstruction due to a large rectal tumor and underwent abdominoperineal resection. The histopathological examination confirmed the diagnosis of high-grade malignant GIST with multiple lymph nodal metastasis. She was started on adjuvant imatinib therapy and is on follow-up without any evidence of recurrence.The authors conclude that GIST must be included in the differential diagnosis of a rectal tumor. Diagnosis is established by biopsy and immunohistochemistry studies. Surgical resection with histological negative margins is the standard curative treatment. Adjuvant targeted therapy can reduce long-term recurrence in high-risk cases.

Gastrointestinal stromal tumour of the rectum: a report of two cases

The Pan African medical journal, 2012

Gastrointestinal stromal tumours (GISTs) are the most common mesenchymal tumours of the gastrointestinal tract in adults, although rectal localisation of these tumours is very rare. We report here two cases of rectal stromal tumours in a 77-year-old woman and a 65-year-old man, confirmed by histology and immunohistochemistry. Surgery for rectal GIST patients is the standard treatment and adjuvant imatinib, a tyrosine kinase inhibitor, is indicated for GISTs with a high risk of malignancy, as well as in the case of metastatic or unresectable tumours.

A rare case of rectal gastrointestinal stromal tumour: diagnosis and management

International Surgery Journal

Gastrointestinal stromal tumours are frequently defined as KIT-(CD117) or PDGFRA-positive mesenchymal spindle cell tumors. Gastrointestinal stromal tumors most commonly occur in the stomach and small intestine, with up to 5% of GISTs occurring in the colon and rectum. We presented a case of distal rectal GIST diagnosed by colonoscopy, colonoscopy with biopsy, computed tomography. The patient underwent Abdominoperineal resection (APR) and was confirmed on histopathology to have rectal GIST with tumor size more than 5 cm and mitotic rate more than 5/50 high power field (HPF). All GISTs are considered to have malignant potential, and, for that reason, all rectal GISTs should be considered for resection.

Gastrointestinal Stromal Tumors in the Rectum

Journal of Biomedical Graphics and Computing, 2013

This radiology case report describes an elderly female patient diagnosed with rectal gastrointestinal stromal tumor (GIST). Although these tumors frequently occur in the gastrointestinal tract (~70%), they are relatively rare in the rectum (~0.1%). Computed tomography (CT) scans showed a tumor invading the rectal wall, radiating laterally into the posterior vaginal wall with well-defined focal necrosis around the lesions. Abdomino-perineal resection and posterior vaginectomy followed by histological and immunocytochemical analyses of biopsied tissue verified further the presence of a high grade GIST using primary antibodies directed against CD 117 and CD 34. These data support the hypothesis that GISTs are pathologically related to mutations in receptors for tyrosine kinase pathways, and suggest that elderly individuals might be at risk for developing ectopic forms of GISTs.

Transvaginal excision of a large rectal stromal tumor: an alternative

The American Journal of Surgery, 2006

Background: Gastrointestinal stromal tumors (GISTs), the specific kit-positive mesenchymal tumors of the gastrointestinal tract, are rarely found in the anorectum and account for only 0.1% of all colorectal tumors. The main stem of therapy remains surgical excision. The standard surgical approach for anorectal GISTs includes transanal resection or enucleation for smaller and anterior or abdominoperineal resection for larger tumors. Methods: We present an alternative, transvaginal approach for a local excision of a large rectal GIST. In our case, a 5 ϫ 5 ϫ 8 cm large GIST located 3 cm above the dentate line in the anterior rectal wall was removed through the vagina. Results: In our experience, this approach enables a safe alternative even for larger tumors in the anterior rectal wall with a very low morbidity, sparing the patient from an unnecessary abdominoperineal resection.

Distinctive features of gastrointestinal stromal tumors arising from the colon and rectum

Journal of gastrointestinal oncology, 2018

Colon and rectal gastrointestinal stromal tumors (GISTs) are rare and poorly characterized. Because the majority of treatment guidelines for GISTs are extrapolated from tumors of gastric and small bowel origin, our aim was to better characterize the unique clinicopathologic features and prognostic factors of colon and rectal GISTs to guide clinical care. The National Cancer Data Base (NCDB) was queried from 2006 to 2013 for cases of GISTs in the stomach, colon, and rectum. Patient demographics, clinical characteristics, and survival were compared. A total of 11,302 gastric GISTs were compared to 398 colon and 393 rectal GISTs. After propensity matching, compared to gastric GISTs, rectal GISTs had improved overall survival (HR =0.695, P=0.0264), while colon GISTs had worse overall survival (HR =1.6, P=0.0005). Surgical treatment for rectal GISTs was more likely to be local excision compared to colonic GISTs (51.1% 8.4%, P<0.0001). Colon and gastric GISTs were less likely to receiv...

Diagnosis and Management of Rectal Gastrointestinal Stromal Tumour (GIST), a Case Report

2019

Case Report Gastrointestinal stromal tumour (GIST) are mesenchymal tumours containing spindle cells which originate from intestinal cell of Cajal, and showing CD117 positivity. Rectal GIST is rare, but the symptoms are the same with other rectal neoplasia. We report a case of a woman who presented with intermittent per rectal bleeding, mucous and faecal incontinence for two months. CT scan and MRI were done, and diagnosis was confirmed with tissue biopsy. She underwent Abdomino-Perineal Resection (APR) and recovered uneventfully. The diagnostic work-up, prognostic factors, choices of surgical treatment, and outcome of rectal GIST with imatinib therapy are discussed in this article. Keyword: Rectal; GIST; Diagnosis; Surgery; Imatinib. Copyright @ 2019: This is an open-access article distributed under the terms of the Creative Commons Attribution license which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use (NonCommercial, or CC-BY-NC) pro...

Diagnostic conundrum of a perineal tumour: a rectal gastrointestinal stromal tumour mimic

The Malaysian journal of pathology, 2017

Gastrointestinal stromal tumour (GIST) is a common mesenchymal tumour arising in the gastrointestinal tract, but not frequently encountered in the rectum. Herein, we describe a case of a rectal GIST which mimicked histomorphological features of a schwannoma; thus, making intraoperative frozen section evaluation challenging. Although subsequent immunohistochemistry and molecular findings readily confirmed the diagnosis of a GIST, we wish to draw attention to three clues that will help the pathologist steer clear of this potential diagnostic pitfall. One, GISTs are relatively more common than schwannomas in the rectum. Two, schwannomas usually have very little mitoses. Three, rectal GISTs commonly exhibit nuclear palisades. We also discuss the diagnostic, prognostic and therapeutic functions of immunohistochemical and molecular investigations. As the surgical intent for rectal GISTs is for en-bloc excision with wide margins, we surmise that the intraoperative consult should include GI...