Turruelles RA, Sánchez BEC, Ricardo MD

Language: Spanish
References: 10
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ABSTRACT

Introduction: the Gastrointestinal Stroma Tumors (GIST), the neoplasia from which those stem are those of highest mesenquimatic frequency of the digestive tract, However, it represents less than 1 % of all these tumors. At present, mesenquimales name the tumors GIST CD117 positive, fusiform or epithelioid, primary of the tract gastrointestinal, epiplón, mesentery and retro-peritoneum.
Case presentation: we introduced a 60-year-old patient that went through admittance in the Internal Medicine service due to chronic anemia and dyspepsia. To the physical examination through palpationof the abdomen, a tumor in straight hypochondrium and epigastrium is verified, notmeasurable, It is fixed, painful. Complementary tests are also performed, like abdominal echography, esophagus gastroduedenoscopy abdominal CAT and laparoscopy, showing the presence of a tumor of the bigger gastric curvature of approximately 20 cm with exofitic growth. Surgery is performed, coming true total gastrectomy, splenectomy and esofagoyeyunostomy, which have proven to be definite of morbid anatomy, as the inform discloses: Tumor of gastricwall, gastrointestinal fusocellular stroma, of potential bass. Size of the tumor 25cm. Meiotic index of 1 mitosis for 50 HPF with positive Inmunohistochemical for CD117, CD34, treatment fulfilled chemotherapy and it presents a favorable evolution.
Discussion: the GIST symptoms are depended of the tumor size and localization. They had some types of clinical presentation such as gastric perforation or haemorrage.
Conclusion: in the OR we found a gastrointestinal fusocelullar tumor, at the gastric wall. With very aggressive behavior.

REFERENCES

1. Soriano Lorenzo J, Lima Pérez M, Soriano García J, Zaldívar Blanco K, Fleites Clavo V. Tumor del estroma gastrointestinal. An Fac med 2019; 80(2): 214-21.

2. Sahin S, Ekinci O, Seckin S. The Diagnosis and prognostic utility of DOG1 expression on gastrointestinal stromal tumors. Turk Patoloji Dreg 2017; 33(1): 1-8.

3. Haliberto Armenteros B. Presentación de un paciente con tumor estromal gastrointestinal de localización gástrica. CCM 2014; 18(4): 785-92.

4. Von Mehren M, Joensuu H. Gastrointestinal stromal tumors. J Clin Oncol 2018; 36(2): 136-43.

5. Joensuu H, Wadermann E, Sihto H, Eriksson M, Sundby Hall K, Reichardt A, et al. Effecto of KIT and PDGFRA mutations on survival in patients with gastrointestinalstromal tumors trated with adyuvant imatin9ib: an exploratory analysis of a randomized clinical tried. JAMA Oncol 2017; 3(5): 602-9.

6. Gopie P, Mei L, Faber AC, Grossman SR, Smith ST, Boikos SA. Calssification of gastrointestinal stromal tumor síndromes. Endocr Relat Cáncer 2018; 25(2): R49-R58.

7. Casali PG, Zalcberg J, Le Cesne A, Reichardt P, Blay JY, Lindner LH, et al. Ten year progression-free and overall survival in patients with unresectable or metastatic GI stromat tumors: long term analysis of the European Organization for Research and Treatment of cáncer, Italian Sarcoma Group and Australasian Gastrointestinal Trials Groups Inter-group phase III randomized trial on imatininib at two dose levels. J Clin Oncol 2017; 35(15): 1713-20.

8. Verdecía Cañizares C, Villamil Martínez R, Monteros Reyes I, Pineda Frenández D. Tumor estromal gastrointestinal. Rev Cubana Pediatr. [Internet]. 2017 [citado 5/10/2020]; 89(1). Disponible en: http://www.revpediatria.sld.cu/index.php/ped/article/view/157/87

9. Sánchez Hidalgo JM, Duran Martínez M, Molero Payan R, Rufian Peña S, Arjona Sánchez A, Casado Adam A, et al. Gatsrointestinal stromal tumors:a multidisciplinary challenge. World J Gastroenterol 2018; 24(18): 1925-41.

10. Lin M, Du W, Idowu M, Mehren M, Boikos S. Advanced and challenges on managment of gastrointestinal stromal tumors. Front Oncol [Internet]. 2018 [citado 9/12/2020]; 8. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5949718/