Successful en bloc resection of complicated giant stomach gastrointestinal stromal tumor in an elderly patient

Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract and mostly affect the stomach. The size of the tumors vary, ranging from 0.6 cm to 25.5 cm, with a median size of 6.8 cm. Case Report: We report a case of a giant GIST (25×18×8.5...

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Bibliographic Details
Main Authors: Zhi, Bryan Yong Yeoh, Vee, Chuan Hoe, Shu, Ning Kong, Wei, Kiat Ooi, Kar, Yee Chiew, Mohd Firdaus Mohd Hayati
Format: Article
Language:English
English
Published: International Scientific Literature, Inc. 2022
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Online Access:https://eprints.ums.edu.my/id/eprint/28947/1/Successful%20en%20bloc%20resection%20of%20complicated%20giant%20stomach%20gastrointestinal%20stromal%20tumor%20in%20an%20elderly%20patient.pdf
https://eprints.ums.edu.my/id/eprint/28947/2/Successful%20en%20bloc%20resection%20of%20complicated%20giant%20stomach%20gastrointestinal%20stromal%20tumor%20in%20an%20elderly%20patient%20_ABSTRACT.pdf
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Summary:Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract and mostly affect the stomach. The size of the tumors vary, ranging from 0.6 cm to 25.5 cm, with a median size of 6.8 cm. Case Report: We report a case of a giant GIST (25×18×8.5 cm) in an 83-year-old woman, which we believe is the largest reported GIST, in Borneo, Malaysia. She presented with gradually increasing abdominal distension with occasional discomfort on movement for 1 month. Computed tomography revealed a large multilobulated enhancing mass measuring 10×20×22 cm with no clear plane with the posterior gastric wall, duodenum, and pancreas. We performed a distal gastrectomy and transverse colon segmentectomy, as the tumor was plastered to the mesentery of the transverse colon. Despite extensive surgery, she recovered well after surgery. Due to her advanced age and the tumor size, a tyrosine kinase inhibitor was not given owing to the possibility of adverse effects. Conclusions: The management of GIST is complicated, especially for a huge GIST with local invasion. Despite the benefits of a tyrosine kinase inhibitor, the role of surgery in managing GIST is crucial, especially for patients with huge tumor size, advanced age, and local complications from the tumor.