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Case Reports
. 2007 Jun 28;13(24):3396-9.
doi: 10.3748/wjg.v13.i24.3396.

A gastrointestinal stromal tumor of the duodenum masquerading as a pancreatic head tumor

Sung Ho Kwon  1 , Hee-Jeong Cha, Seok-Won Jung, Byung-Chul Kim, Jae-Serk Park, In-Du Jeong, Jong-Hwa Lee, Yang-Won Nah, Sung-Jo Bang, Jung-Woo Shin, Neung-Hwa Park, Do-Ha Kim
Affiliations
Case Reports

A gastrointestinal stromal tumor of the duodenum masquerading as a pancreatic head tumor

Sung Ho Kwon et al. World J Gastroenterol. .

Abstract

Gastrointestinal stromal tumor (GIST) represents the most common kind of mesenchymal tumor that arises from the alimentary tract. GIST is currently defined as a gastrointestinal tract mesenchymal tumor showing CD117 (c-kit protein) positivity at immunohistochemistry. Throughout the whole length of the gastrointestinal tract, GIST arises most commonly from the stomach followed by the small intestine, the colorectum, and the esophagus. Only 3%-5% of GISTs occur in the duodenum, and especially, if GIST arises from the C loop of the duodenum, it can be difficult to differentiate from the pancreas head mass because of its anatomical proximity. Here, we report a case of duodenal GIST, which was assessed as a pancreatic head tumor preoperatively.

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Figures

Figure 1
Figure 1
Duodenal endoscopy neither showed an intraluminal mass nor a mucosal abnormality under good visualization to the fourth part of the duodenum.
Figure 2
Figure 2
Abdominal ultrasound showed 2.3 cm sized, oval-shaped hypoechoic solid nodule around the uncinate process of the pancreas (arrow).
Figure 3
Figure 3
The CT scan of upper abdomen showed an intense homogenously enhancing tumor with 2.3 cm in diameter in the pancreatic head region (arrow).
Figure 4
Figure 4
Macroscopic appearance of the resected specimens; a round yellow gray colored tumor of cut surface (arrows) indicated the submucosal mass growing outwards towards the duodenal lumen.
Figure 5
Figure 5
A well-defined subserosal duodenal GIST showing interlacing fascicles of the spindle cells with elongated cytoplasm (H&E stain; A: × 20, B: × 200).
Figure 6
Figure 6
The tumor cells react positively for CD34 (A: × 200) and c-kit (B: × 200) while negative for SMA (C: × 100) on immunohistochemistry.
See this image and copyright information in PMC

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