Duodenal GIST Presenting as Large Pancreatic Head Mass: An Uncommon Presentation

  • Sumitoj Singh Government Medical College. Amritsar, India
  • Surinder Paul Government Medical College. Amritsar, India
  • Pawan Khandelwal Government Medical College. Amritsar, India
  • Sudhir Khichy Government Medical College. Amritsar, India
Keywords: Duodenum, Gastrointestinal Stromal Tumors

Abstract

Context Duodenal gastrointestinal stromal tumors (GIST) are uncommon. They usually present with gastrointestinal bleed, upper abdominal pain or mass abdomen. Tumor arising from the second part of duodenum can be wrongly diagnosed as pancreatic mass. Case report We present a case of a thirty-year-old male who came with chief complaint of mass upper abdomen. On laparotomy there was a 15x10 cm mass arising from the whole of anterior surface head of pancreas and was attached with the second part of duodenum for about 1-2 cm only. Patient underwent pancreaticoduodenectomy and histopathology revealed that tumor was arising from the duodenal wall. Conclusion Duodenal gastrointestinal stromal tumors can grow exophytically into large mass and involve the pancreas without infiltrating microscopically and present as pancreatic head mass.

Image: Macroscopic appearance of resected specimens showing tumor attached mainly along the pancreatic head.

Downloads

Download data is not yet available.

Author Biographies

Sumitoj Singh, Government Medical College. Amritsar, India

Assistant professor

Department of General Surgery

Surinder Paul, Government Medical College. Amritsar, India

Associate Professor

Department of Pathology

 

Pawan Khandelwal, Government Medical College. Amritsar, India

Junior Resident

Department of General Surgery

Sudhir Khichy, Government Medical College. Amritsar, India

Professor and Head

Department of General Surgery

 

References

Beham AW, Schaefer IM, Schüler P, Cameron S, Ghadimi BM. Gastrointestinal stromal tumors. Int J Colorectal Dis. 2012; 27:689-700. [PMID 22124674]

Beham A, Schaefer IM, Cameron S, von Hammerstein K, Füzesi L, Ramadori G, Ghadimi MB. Duodenal GIST: a single center experience. Int J Colorectal Dis. 2012 Feb 22. [Epub ahead of print] [PMID 22350270]

Buchs NC, Bucher P, Gervaz P, Ostermann S, Pugin F, Morel P. Segmental duodenectomy for gastrointestinal stromal tumor of the duodenum. World J Gastroenterol. 2010; 16:2788-92. [PMID 20533599]

Miettinen M, Kopczynski J, Makhlouf HR, Sarlomo-Rikala M, Gyorffy H, Burke A, Sobin LH, et al. Gastrointestinal stromal tumors, intramural leiomyomas, and leiomyosarcomas in the duodenum: a clinicopathologic, immunohistochemical, and molecular genetic study of 167 cases. Am J Surg Pathol 2003; 27:625-41.[ PMID 12717247]

Grignol VP, Termuhlen PM. Gastrointestinal stromal tumor surgery and adjuvant therapy. Surg Clin North Am 2011; 91:1079-87.[PMID 21889030]

Tan CB, Zhi W, Shahzad G, Mustacchia P. Gastrointestinal stromal tumors: a review of case reports, diagnosis, treatment, and future directions. ISRN Gastroenterol 2012; 2012:595968. Epub 2012 Apr 12. [PMID: 22577569]

Yang WL, Yu JR, Wu YJ, Zhu KK, Ding W, Gao Y, Shen QY, et al. Duodenal gastrointestinal stromal tumor: clinical, pathologic, immunohistochemical characteristics, and surgical prognosis. J Surg Oncol 2009 ;100:606-10.[PMID 19697360]

Choi H. Imaging modalities of gastrointestinal stromal tumors. J Surg Oncol 2011 ;104:907-14.[PMID 22069176]

Kwon SH, Cha HJ, Jung SW, Kim BC, Park JS, Jeong ID, Lee JH, et al. A gastrointestinal stromal tumor of the duodenum masquerading as a pancreatic head tumor. World J Gastroenterol 2007; 13:3396-9. [PMID 17659684]

Uchida H, Sasaki A, Iwaki K, Tominaga M, Yada K, Iwashita Y, Shibata K, et al. An extramural gastrointestinal stromal tumor of the duodenum mimicking a pancreatic head tumor. J Hepatobiliary Pancreat Surg 2005; 12:324-7. [PMID 16133702]

Frampton AE, Bong JJ, Kyriakides C, Cohen P, Jiao LR. En bloc resection of the pancreatic head and second part of duodenum for a duodenal gastrointestinal stromal tumor: a multi-media report. JOP 2010; 11:396-400.[PMID: 20601819]

Sandrasegaran K, Rajesh A, Rushing DA, Rydberg J, Akisik FM, Henley JD. Gastrointestinal stromal tumors: CT and MRI findings. Eur Radiol 2005; 15:1407-14. [PMID 15761716]

Tien YW, Lee CY, Huang CC, Hu RH, Lee PH. Surgery for gastrointestinal stromal tumors of the duodenum. Ann Surg Oncol 2010; 17:109-14. [ PMID 19841981]

Chung JC, Chu CW, Cho GS, Shin EJ, Lim CW, Kim HC, Song OP. Management and outcome of gastrointestinal stromal tumors of the duodenum. J Gastrointest Surg 2010; 14:880-3.[PMID 20140534]

Miki Y, Kurokawa Y, Hirao M, Fujitani K, Iwasa Y, Mano M, Nakamori S, et al. Survival analysis of patients with duodenal gastrointestinal stromal tumors. J Clin Gastroenterol 2010 ;44:97-101.[ PMID 19809358]

Eisenberg BL, Trent JC. Adjuvant and neoadjuvant imatinib therapy: current role in the management of gastrointestinal stromal tumors. Int J Cancer 2011 ;129:2533-42. [PMID: 21671474]

Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, et al Diagnosis of gastrointestinal stromal tumors: A consensus approach. Hum Pathol 2002; 33:459-465. [PMID:12094370]

Agaimy A. Gastrointestinal stromal tumors (GIST) from risk stratification systems to the new TNM proposal: more questions than answers? A review emphasizing the need for a standardized GIST reporting. Int J Clin Exp Pathol. 2010; 3:461-71. [PMID: 20606727]

Pisters PW, Colombo C. Adjuvant imatinib therapy for gastrointestinal stromal tumors. J Surg Oncol. 2011; 104:896-900 [ PMID: 22069174]

Macroscopic appearance of resected specimens showing tumor attached mainly along the pancreatic head
Published
2012-11-10
How to Cite
SinghS., PaulS., KhandelwalP., & KhichyS. (2012). Duodenal GIST Presenting as Large Pancreatic Head Mass: An Uncommon Presentation. JOP. Journal of the Pancreas, 13(6), 696-699. https://doi.org/10.6092/1590-8577/1213