Case report

A case of gastrointestinal stromal tumor with spontaneous rupture in the greater omentum

Norihiro Yoshimura¹ , Hirotaka Ohara² , Katsuyuki Miyabe¹ , Tessin Ban¹ , Hitoshi Sano¹ , Itaru Naitoh² , Kazuki Hayashi² , Tomoaki Ando² , Takahiro Nakazawa² and Takashi Joh²

¹  Department of Gastroenterology, Gifu Prefectural Tajimi Hospital, 5-161 Maehatacho, Tajimi, Gifu, 507-8522, Japan

²  Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho, Nagoya, Aichi, 467-8601, Japan

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International Seminars in Surgical Oncology 2008, 5:19doi:10.1186/1477-7800-5-19

Published:	29 July 2008

Abstract

Background

Although GIST generally occurs in the digestive tract, such as the stomach, and small and small intestine primarily, Omental GIST tumours are very rare.

Case Presentation

A 63-year-old male patient, who recognized an abdominal tumor 1 year before admission, had a slight expansion of the tumor, reduction of the body and malaise, was consulted to our hospital. Abdominal CT and MRI revealed a cystic lesion of 26 cm in diameter with a clear boundary from immediately below the interseptum to the pelvic cavity, and imaged the septum and cystic wall. We considered that the patient had a cystic tumor in the abdomen, of which the primary lesion was unknown, and scheduled surgery. The patient unfortunately deteriorated with shock and sudden pain in the abdomen. Wediagnosed tumor rapture, and emergency surgery was performed. The tumor, weighing 3,600 g, was mostly cystic, and filled with sanguinous fluid and clot. Histologically, the tumor was composed of spindle cells, and was positive for c-KIT (CD117), slightly positive for alpha-smooth muscle actin (SMA), and S-100 protein positive. Based on these findings, the tumor was diagnosed as GIST primarily occurring in the greater omentum.

Conclusion

We experienced a rare case of GIST which originated from the greater omentum. Recently, the prognosis of GIST has been improved since the treatment with Imatinib.

It is necessary to consider the diagnosis of GIST on encountering a mass in the greater omentum.