Perforation as a rare presentation of gastric gastrointestinal stromal tumours: a case report and review of the literature

Abstract

Introduction: Gastrointestinal stromal tumours (GISTs) are the most common connective tissue neoplasms of the gastrointestinal tract, the most common clinical presentation of which is with abdominal pain or gastrointestinal bleeding.

Methods: We describe a case of a perforated gastric GIST as well as reviewing the relevant published literature.

Results: A 51-year-old woman presented to the acute assessment unit with a 1-day history of severe epigastric pain on a background of longstanding reflux symptoms. Radiological investigation demonstrated a perforated mass in the gastric antrum and the patient subsequently underwent an emergency distal gastrectomy. She recovered well postoperatively and was discharged home. Her condition remains stable six months following surgery. Histological analysis revealed the perforated lesion to be a GIST. A PubMed search suggests that this is the first English report to describe a perforated gastric GIST. Six further published reports (written in English or with an English abstract) describing the presentation of small bowel GISTs with perforation are reviewed.

Conclusions: We present the first English report of a perforated gastric GIST. More common presentations include abdominal pain and gastrointestinal bleeding. Although rare, GISTs should be considered in the differential diagnoses of perforated gastrointestinal masses.

Figure 1

Axial and sagittal contrast enhanced computed tomography of a thickened and heterogeneously enhancing mass in the gastric antrum (dark arrow) with surrounding soft tissue stranding and localised free air anterior to the mass (light arrow)