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Case Reports
. 2016 Dec 21;3(4):e189.
doi: 10.14309/crj.2016.162. eCollection 2016 Aug.

A Bleeding Duodenal GIST Masquerading as Refractory Peptic Ulcer Disease

Jason D Jones  1 , Stephen Oh  2 , Clancy Clark  3 , Rishi Pawa  2
Affiliations
Case Reports

A Bleeding Duodenal GIST Masquerading as Refractory Peptic Ulcer Disease

Jason D Jones et al. ACG Case Rep J. .

Abstract

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract; however, the occurrence of a GIST in the duodenum is rare. Our case demonstrates the importance of considering GIST in the evaluation of refractory duodenal ulcers, as well as the utilization of endoscopic ultrasound in the evaluation of these lesions.

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Figures

Figure 1
Figure 1
Contrast-enhanced computed tomography scan showing the junction of the second and third portion of the duodenum (arrow) without evidence of mass lesion.
Figure 2
Figure 2
Endoscopic appearance of 8-mm superficial ulcer in the second portion of the duodenum.
Figure 3
Figure 3
Endoscopic ultrasound revealing a 9.6 x 13 mm oval, hypoechoic, homogeneous mass in the second portion of the duodenum arising from the muscularis propria (arrow).
Figure 4
Figure 4
Duodenal sections reveal (A) a well-circumscribed tumor in the muscularis propria (4x) and (B) bland spindle cell proliferation (40x). No pronounced pleomorphism, necrosis, or increased mitotic activity noted.
Figure 5
Figure 5
Immunohistochemical staining revealed that the neoplastic cells were intensely and diffusely positive for CD117, which supports the diagnosis of GI stromal tumor (2x).
See this image and copyright information in PMC

References

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