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Malignant gastrointestinal stromal tumor presenting with hemoperitoneum in puerperium: report of a case with review of the literature

BACKGROUND: Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors that develop in the wall of the gastrointestinal tract and their diagnosis during pregnancy or puerperium is extremely rare. CASE: A 28-year old patient presented with acute abdomen due to hemoperitoneum from a large mass ari...

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Autores principales: Varras, Michail, Vlachakos, Nikolaos, Akrivis, Christodoulos, Vasilakaki, Thivi, Skafida, Evangelia
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2993706/
https://www.ncbi.nlm.nih.gov/pubmed/21054898
http://dx.doi.org/10.1186/1477-7819-8-95
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author Varras, Michail
Vlachakos, Nikolaos
Akrivis, Christodoulos
Vasilakaki, Thivi
Skafida, Evangelia
author_facet Varras, Michail
Vlachakos, Nikolaos
Akrivis, Christodoulos
Vasilakaki, Thivi
Skafida, Evangelia
author_sort Varras, Michail
collection PubMed
description BACKGROUND: Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors that develop in the wall of the gastrointestinal tract and their diagnosis during pregnancy or puerperium is extremely rare. CASE: A 28-year old patient presented with acute abdomen due to hemoperitoneum from a large mass arising of the small intestine with distended vessels on its top and a ruptured superficial vessel bleeding into the peritoneal cavity. The patient was at the tenth postpartum day of her first pregnancy. The preoperative diagnosis was a possible ovarian or uterine mass. After an emergency exploratory laparotomy a segmental bowel resection was performed, removing the tumor with a part of 3-cm of the small intestine. Histology revealed GIST with maximum diameter of 13 cm and mitotic rates more than 5 mitoses per 50 high power fields with some atypical forms, indicating a high risk malignancy. Immunohistochemical staining of the tumor tissue demonstrated strongly positive reactivity to CD 117 (c-kit) and CD34 in almost all the tumor cells. The patient was treated with oral imatinib mesylate (Gleevec) 400 mg daily for one year. Three years after surgery, the patient was alive without evidence of metastases or local recurrence. CONCLUSION: Considering that only few patients with gastrointestinal stromal tumors have been reported in the obstetrical and gynecological literature, the awareness of such an entity by the obstetricians-gynecologists is necessary in order to facilitate coordinated approach with the general surgeons and oncologists for the optimal care of the patients.
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spelling pubmed-29937062010-11-30 Malignant gastrointestinal stromal tumor presenting with hemoperitoneum in puerperium: report of a case with review of the literature Varras, Michail Vlachakos, Nikolaos Akrivis, Christodoulos Vasilakaki, Thivi Skafida, Evangelia World J Surg Oncol Case Report BACKGROUND: Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors that develop in the wall of the gastrointestinal tract and their diagnosis during pregnancy or puerperium is extremely rare. CASE: A 28-year old patient presented with acute abdomen due to hemoperitoneum from a large mass arising of the small intestine with distended vessels on its top and a ruptured superficial vessel bleeding into the peritoneal cavity. The patient was at the tenth postpartum day of her first pregnancy. The preoperative diagnosis was a possible ovarian or uterine mass. After an emergency exploratory laparotomy a segmental bowel resection was performed, removing the tumor with a part of 3-cm of the small intestine. Histology revealed GIST with maximum diameter of 13 cm and mitotic rates more than 5 mitoses per 50 high power fields with some atypical forms, indicating a high risk malignancy. Immunohistochemical staining of the tumor tissue demonstrated strongly positive reactivity to CD 117 (c-kit) and CD34 in almost all the tumor cells. The patient was treated with oral imatinib mesylate (Gleevec) 400 mg daily for one year. Three years after surgery, the patient was alive without evidence of metastases or local recurrence. CONCLUSION: Considering that only few patients with gastrointestinal stromal tumors have been reported in the obstetrical and gynecological literature, the awareness of such an entity by the obstetricians-gynecologists is necessary in order to facilitate coordinated approach with the general surgeons and oncologists for the optimal care of the patients. BioMed Central 2010-11-07 /pmc/articles/PMC2993706/ /pubmed/21054898 http://dx.doi.org/10.1186/1477-7819-8-95 Text en Copyright ©2010 Varras et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Varras, Michail
Vlachakos, Nikolaos
Akrivis, Christodoulos
Vasilakaki, Thivi
Skafida, Evangelia
Malignant gastrointestinal stromal tumor presenting with hemoperitoneum in puerperium: report of a case with review of the literature
title Malignant gastrointestinal stromal tumor presenting with hemoperitoneum in puerperium: report of a case with review of the literature
title_full Malignant gastrointestinal stromal tumor presenting with hemoperitoneum in puerperium: report of a case with review of the literature
title_fullStr Malignant gastrointestinal stromal tumor presenting with hemoperitoneum in puerperium: report of a case with review of the literature
title_full_unstemmed Malignant gastrointestinal stromal tumor presenting with hemoperitoneum in puerperium: report of a case with review of the literature
title_short Malignant gastrointestinal stromal tumor presenting with hemoperitoneum in puerperium: report of a case with review of the literature
title_sort malignant gastrointestinal stromal tumor presenting with hemoperitoneum in puerperium: report of a case with review of the literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2993706/
https://www.ncbi.nlm.nih.gov/pubmed/21054898
http://dx.doi.org/10.1186/1477-7819-8-95
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