Gastroduodenal intussusception caused by gastric gastrointestinal stromal tumor in adults: a case report and literature review

Abstract

Intussusception mostly occurs in childhood and is rare in adults. Although intussusception can occur in any part of the gastrointestinal tract, gastroduodenal intussusception caused by a gastric tumor is relatively uncommon in clinical practice. A PubMed search identified 24 published cases of gastroduodenal intussusception caused by gastric gastrointestinal stromal tumor (GIST); however, it is possible that we missed other cases not included in PubMed. Here we report a case of gastroduodenal intussusception caused by gastric GIST in an 85-year-old man. He came to the hospital because of recurrent black stools. Plain computed tomography (CT) scan indicated a mass in the gastric antrum, with slight enhancement in the arterial phase on enhanced CT scan. He was diagnosed with GIST. In addition, images indicated that the mass overlapped into the duodenum, and gastroduodenal intussusception was thus considered. Gastroscopy showed a huge mass in the gastric body. According to the gastroscopy and CT results, gastroduodenal intussusception caused by a gastric tumor was considered. The patient underwent complete surgical removal, which revealed a mass originating from the gastric antrum and overlapping into the duodenum. The postoperative pathological diagnosis was intermediate-risk gastric GIST. The patient was followed up for 4 months without tumor recurrence.

Keywords: Gastroduodenal intussusception; adult; duodenum; gastric tumor; gastrointestinal stromal tumor; surgery.

Figure 1.

Gastroscopic examination revealed uplifted mucosa (arrows) of the gastric body and overlap into the duodenum (a) and Endoscopic reduction was performed (arrows) (b).

Figure 2.

Enhanced computed tomography scan showed a mass (arrows) with slight enhancement in the arterial (a) and venous (b) phases on 27 July 2021.

Figure 3.

A mass measuring 6 cm × 5 cm (arrows) overlapped into the duodenum and was found to originate from the gastric antrum.

Figure 4.

Pathological examination. (a) Hematoxylin–eosin staining showed that the cells were epithelioid (×100). Representative immunohistochemistry for (b) CKP, (c) CD117, (d) CD34, (e) DOG-1, and (f) SDHB (×100).