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A ruptured jejunal gastrointestinal stromal tumor with hemoperitoneum mimicking ovarian carcinoma.
Int J Clin Exp Pathol. 2020; 13(1):49-53.IJ

Abstract

BACKGROUND

Gastrointestinal stromal tumor (GIST) of the small bowel is a rare malignancy and accounts for only 0.1-3% of all gastrointestinal neoplasms. GISTs may mimic gynecologic tumors. The authors present an unusual case of ruptured jejunal GIST with hemoperitoneum mimicking ovarian carcinoma.

CASE PRESENTATION

A 57-year-old postmenopausal woman presented with progressive, generalized low abdominal pain for 3 months. Computed tomography (CT) imaging depicted a 9.6 cm-sized, complex and solid mass on the left pelvic cavity and a 3.7 cm-sized heterogeneous, enhancing mass on the right adnexa, suspicious for ovarian cancer accompanied by hemoperitoneum. There was no active bleeding. Laboratory examination revealed a low level of serum hemoglobin (6.7 g/dL), and a raised serum level of CA-125 (107.0 U/mL). Based on CT imaging findings and an elevated serum level of CA-125, bilateral ovarian cancer was suspected. The patient underwent exploratory laparotomy, and frozen section of the excised mass indicated malignancy originating from the small bowel jejunum. Consequently, small bowel segmental resection with mesenteric resection was done, and a debulking operation including hysterectomy, BSO, BPLD, omentectomy, and excision of multiple metastatic masses in the peritoneum was performed. Subsequent histopathologic examination confirmed the final diagnosis of high risk GISTs of the primary small bowel jejunum. The patient's postoperative course was uneventful, and adjuvant Imatinib was administered.

CONCLUSION

The authors report an unusual case of ruptured jejunal GIST with hemoperitoneum mimicking ovarian carcinoma. Therefore, GIST, in addition to ovarian cancer, should be considered in patients with an increased serum level of CA-125 and an abdominopelvic mass.

Authors+Show Affiliations

Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Pusan National University Hospital and Pusan National University College of Medicine Busan, Republic of Korea.Department of General Surgery, Pusan National University School of Medicine Busan, Republic of Korea.Department of General Surgery, Pusan National University School of Medicine Busan, Republic of Korea.Department of General Surgery, Pusan National University School of Medicine Busan, Republic of Korea.Department of Radiology, Pusan National University School of Medicine Busan, Republic of Korea.Department of Pathology, Pusan National University School of Medicine Busan, Republic of Korea.Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Pusan National University Hospital and Pusan National University College of Medicine Busan, Republic of Korea.

Pub Type(s)

Case Reports

Language

eng

PubMed ID

32055272

Citation

Hwang, Seo Yoon, et al. "A Ruptured Jejunal Gastrointestinal Stromal Tumor With Hemoperitoneum Mimicking Ovarian Carcinoma." International Journal of Clinical and Experimental Pathology, vol. 13, no. 1, 2020, pp. 49-53.
Hwang SY, Choi CI, Cho HJ, et al. A ruptured jejunal gastrointestinal stromal tumor with hemoperitoneum mimicking ovarian carcinoma. Int J Clin Exp Pathol. 2020;13(1):49-53.
Hwang, S. Y., Choi, C. I., Cho, H. J., Kim, D. H., Hong, S. B., Choi, K. U., & Suh, D. S. (2020). A ruptured jejunal gastrointestinal stromal tumor with hemoperitoneum mimicking ovarian carcinoma. International Journal of Clinical and Experimental Pathology, 13(1), 49-53.
Hwang SY, et al. A Ruptured Jejunal Gastrointestinal Stromal Tumor With Hemoperitoneum Mimicking Ovarian Carcinoma. Int J Clin Exp Pathol. 2020;13(1):49-53. PubMed PMID: 32055272.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A ruptured jejunal gastrointestinal stromal tumor with hemoperitoneum mimicking ovarian carcinoma. AU - Hwang,Seo Yoon, AU - Choi,Chang In, AU - Cho,Hong Jae, AU - Kim,Dae Hwan, AU - Hong,Seung Baek, AU - Choi,Kyung Un, AU - Suh,Dong Soo, Y1 - 2020/01/01/ PY - 2019/08/16/received PY - 2019/09/27/accepted PY - 2020/2/15/entrez PY - 2020/2/15/pubmed PY - 2020/2/15/medline KW - Gastrointestinal stromal tumors (GISTs) KW - jejunum KW - small bowel and mesentery SP - 49 EP - 53 JF - International journal of clinical and experimental pathology JO - Int J Clin Exp Pathol VL - 13 IS - 1 N2 - BACKGROUND: Gastrointestinal stromal tumor (GIST) of the small bowel is a rare malignancy and accounts for only 0.1-3% of all gastrointestinal neoplasms. GISTs may mimic gynecologic tumors. The authors present an unusual case of ruptured jejunal GIST with hemoperitoneum mimicking ovarian carcinoma. CASE PRESENTATION: A 57-year-old postmenopausal woman presented with progressive, generalized low abdominal pain for 3 months. Computed tomography (CT) imaging depicted a 9.6 cm-sized, complex and solid mass on the left pelvic cavity and a 3.7 cm-sized heterogeneous, enhancing mass on the right adnexa, suspicious for ovarian cancer accompanied by hemoperitoneum. There was no active bleeding. Laboratory examination revealed a low level of serum hemoglobin (6.7 g/dL), and a raised serum level of CA-125 (107.0 U/mL). Based on CT imaging findings and an elevated serum level of CA-125, bilateral ovarian cancer was suspected. The patient underwent exploratory laparotomy, and frozen section of the excised mass indicated malignancy originating from the small bowel jejunum. Consequently, small bowel segmental resection with mesenteric resection was done, and a debulking operation including hysterectomy, BSO, BPLD, omentectomy, and excision of multiple metastatic masses in the peritoneum was performed. Subsequent histopathologic examination confirmed the final diagnosis of high risk GISTs of the primary small bowel jejunum. The patient's postoperative course was uneventful, and adjuvant Imatinib was administered. CONCLUSION: The authors report an unusual case of ruptured jejunal GIST with hemoperitoneum mimicking ovarian carcinoma. Therefore, GIST, in addition to ovarian cancer, should be considered in patients with an increased serum level of CA-125 and an abdominopelvic mass. SN - 1936-2625 UR - https://www.unboundmedicine.com/medline/citation/32055272/A_ruptured_jejunal_gastrointestinal_stromal_tumor_with_hemoperitoneum_mimicking_ovarian_carcinoma_ L2 - https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/32055272/ DB - PRIME DP - Unbound Medicine ER -
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