Gastrointestinal stromal tumor of the ileum – case report of life-threatening bleeding

Abstract

Introduction Gastrointestinal stromal tumor (GIST) is relatively rare neoplasm and according to data in the literature, makes up less than 1% of all tumors of the gastrointestinal tract with the most frequent incidence in the sixth decade of life. The development and discovery of new molecular, biochemical and immunohistochemical methods contributed significantly to the successful identification and better understanding of this type of neoplasm. The most common localization of GIST is stomach, causing merely discomfort and occasional pain in the abdomen as the only complaint. Case Outline Our patient, a 71-year-old male, came for an outpatient surgical examination due to gastrointestinal bleeding and low hemoglobin values in laboratory findings. We conducted the endoscopic examination of the upper parts of the digestive tract; there were neither active nor old signs of gastrointestinal bleeding. The patient underwent an ultrasound examination and then a computed tomography (CT) of the abdomen. CT scan showed tumor mass in the lower parts of abdominal cavity, highly suspicious for GIST of small intestine (ileum). The patient underwent emergency surgery, with the resection of bleeding tumor and creation of primary anastomosis. The patient recovered well from the surgery and was discharged home in good general condition. Conclusion The goal of surgery is to achieve an optimal resection line R0 with an intact pseudocapsule of the tumor. Postoperative adjuvant therapy with imatinib is indicated in certain cases, in order to ensure the most favorable clinical and oncological outcome. © 2024, Serbia Medical Society. All rights reserved.