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DOI: 10.1055/s-0030-1256255
© Georg Thieme Verlag KG Stuttgart · New York
Gastrointestinal stromal tumor (GIST) presenting with acute pancreatitis
V. Senadhi
Johns Hopkins University/Sinai Hospital Program in Internal
Medicine
2606B Gage Court
Baltimore
Maryland
21209
USA
Fax: +1-678-623-5999
Email: vsenadhi@hotmail.com
Publication History
Publication Date:
02 March 2011 (online)
A 58-year old woman presented with constant epigastric abdominal pain radiating to her back, of 1 week’s duration. The patient had associated nausea, vomiting, anorexia, and weight loss. Physical examination revealed midepigastric tenderness without a palpable mass. Pertinent laboratory values included serum amylase of 410 units/L and lipase of 471 units/L.
Abdominal computed tomography (CT) scan revealed a 6-cm cystic mass between the stomach and pancreas, as well as mild pancreatitis ([Fig. 1]). Upper endoscopy showed extrinsic compression of the stomach along the lesser curvature, prohibiting passage of the scope to the pylorus. Endoscopic ultrasound revealed a 6 × 6-cm heterogeneous, well-rounded mass with calcifications and a calcified rim originating from the gastric mucosa, along with upstream dilation of the pancreatic duct to 1 cm ([Fig. 2]). Fine-needle aspiration revealed spindle cells. During surgery, a well-rounded mass originating from the gastric antrum was found to have prolapsed into the second portion of the duodenum, obstructing the pancreatic duct. The patient underwent a partial resection of the anterior gastric wall. Final surgical pathology revealed diffuse c-kit positivity, confirming the mass was a gastrointestinal stromal tumor (GIST). Postoperatively, the patient’s pancreatitis resolved, and she has not had a recurrence of her pancreatitis.
Although there are reports of duodenal GISTs mimicking pancreatic cancer, there are no known reports where acute pancreatitis (fulfilling two of three criteria) is secondary to a GIST [1]. In conclusion, we report a rare case of gastrointestinal stromal tumor presenting as acute pancreatitis, which, to our knowledge, is the first reported case in the literature.
Endoscopy_UCTN_Code_CCL_1AB_2AD_3AB
Competing interests: None
#References
- 1 Soufi M, Chad B. Stromal duodenal tumor revealed by an acute pancreatitis: report of a case. J Gastrointest Canc. 2010; 41 88-91
V. Senadhi
Johns Hopkins University/Sinai Hospital Program in Internal
Medicine
2606B Gage Court
Baltimore
Maryland
21209
USA
Fax: +1-678-623-5999
Email: vsenadhi@hotmail.com
References
- 1 Soufi M, Chad B. Stromal duodenal tumor revealed by an acute pancreatitis: report of a case. J Gastrointest Canc. 2010; 41 88-91
V. Senadhi
Johns Hopkins University/Sinai Hospital Program in Internal
Medicine
2606B Gage Court
Baltimore
Maryland
21209
USA
Fax: +1-678-623-5999
Email: vsenadhi@hotmail.com