Duodenal Gastrointestinal Stromal Tumor Treated by Wedge Resection: A Case Report

Yoshifumi Nakayama, Masaki Akiyama, Yusuke Sawatsubashi, Jun Nagata, Kazunori Shibao, Keiji Hirara

Abstract


This report describes a patient with a duodenal gastrointestinal stromal tumor (GIST). A 77-year-old Japanese male presented with abdominal fullness and weight loss. Computed tomography (CT) of the abdomen demonstrated an enhanced mass, 4 × 3 cm in size, at the right side of the inferior vena cava. An endoscopic examination revealed a duodenal submucosal tumor. He was referred to the surgical outpatient clinic for surgical treatment of a duodenal submucosal tumor. Laparotomy allowed for the identification of a nut-sized extramural tumor at the second portion of the duodenum. Wedge resection of the duodenum including the tumor was performed. A histopathological examination revealed that the tumor was composed of a proliferation of spindle cells with spindle nuclei and eosinophilic fibrillar cytoplasm, arranged in fascicles with a hypercellular area. An immunohistochemical examination revealed that these tumor cells were positive for c-kit, CD34, and S-100 and were negative for SMA. The mitotic figures were less than 1 in 20 high-power fields. This duodenal tumor was diagnosed as a low-risk GIST. The patient had an uneventful recovery and was discharged from the hospital on Day 17 after the operation. This report presents a rare surgical case of duodenal GIST treated with wedge resection of the duodenum.


Keywords


gastrointestinal stromal tumor, duodenum, wedge resection

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