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Giant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort: a case report

BACKGROUND: Gastrointestinal stromal tumors (GISTs) grow relatively slowly and without specific symptoms; therefore, they are typically incidental findings. We report a rare gastric GIST in the mediastinum associated with chest discomfort and an esophageal hiatal hernia. CASE PRESENTATION: An 81-yea...

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Autores principales: Fujisawa, Ryosuke, Akiyama, Yuji, Iwaya, Takeshi, Endo, Fumitaka, Nikai, Haruka, Baba, Shigeaki, Chiba, Takehiro, Kimura, Toshimoto, Takahara, Takeshi, Otsuka, Koki, Nitta, Hiroyuki, Mizuno, Masaru, Koeda, Keisuke, Sasaki, Akira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6292835/
https://www.ncbi.nlm.nih.gov/pubmed/30547235
http://dx.doi.org/10.1186/s40792-018-0553-x
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author Fujisawa, Ryosuke
Akiyama, Yuji
Iwaya, Takeshi
Endo, Fumitaka
Nikai, Haruka
Baba, Shigeaki
Chiba, Takehiro
Kimura, Toshimoto
Takahara, Takeshi
Otsuka, Koki
Nitta, Hiroyuki
Mizuno, Masaru
Koeda, Keisuke
Sasaki, Akira
author_facet Fujisawa, Ryosuke
Akiyama, Yuji
Iwaya, Takeshi
Endo, Fumitaka
Nikai, Haruka
Baba, Shigeaki
Chiba, Takehiro
Kimura, Toshimoto
Takahara, Takeshi
Otsuka, Koki
Nitta, Hiroyuki
Mizuno, Masaru
Koeda, Keisuke
Sasaki, Akira
author_sort Fujisawa, Ryosuke
collection PubMed
description BACKGROUND: Gastrointestinal stromal tumors (GISTs) grow relatively slowly and without specific symptoms; therefore, they are typically incidental findings. We report a rare gastric GIST in the mediastinum associated with chest discomfort and an esophageal hiatal hernia. CASE PRESENTATION: An 81-year-old woman with chest discomfort was admitted to the hospital, where barium esophagography showed a sliding esophageal hiatal hernia and a tumor of the lower esophagus and gastric wall. Esophagogastroscopy confirmed the presence of a huge submucosal tumor that extended from the lower esophagus to the gastric fundus. According to computed tomography, the mediastinal mass measured 12.7 cm and had heterogeneous low-density areas. A submucosal gastric tumor, which we suspected to be a GIST, was diagnosed in association with an esophageal hiatal hernia. Using thoracolaparotomy, we performed a total gastrectomy, a lower esophagectomy, and a Roux-en-Y reconstruction with the jejunum. The presumptive diagnosis was confirmed through immunohistochemical examination; immunostaining yielded results positive for CD34 and c-kit. The patient was discharged from the hospital 13 days after surgery with no complications and remained disease-free at follow-up 24 months after surgery. CONCLUSIONS: GIST should be considered in the differential diagnosis of tumors growing in the mediastinum.
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spelling pubmed-62928352018-12-28 Giant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort: a case report Fujisawa, Ryosuke Akiyama, Yuji Iwaya, Takeshi Endo, Fumitaka Nikai, Haruka Baba, Shigeaki Chiba, Takehiro Kimura, Toshimoto Takahara, Takeshi Otsuka, Koki Nitta, Hiroyuki Mizuno, Masaru Koeda, Keisuke Sasaki, Akira Surg Case Rep Case Report BACKGROUND: Gastrointestinal stromal tumors (GISTs) grow relatively slowly and without specific symptoms; therefore, they are typically incidental findings. We report a rare gastric GIST in the mediastinum associated with chest discomfort and an esophageal hiatal hernia. CASE PRESENTATION: An 81-year-old woman with chest discomfort was admitted to the hospital, where barium esophagography showed a sliding esophageal hiatal hernia and a tumor of the lower esophagus and gastric wall. Esophagogastroscopy confirmed the presence of a huge submucosal tumor that extended from the lower esophagus to the gastric fundus. According to computed tomography, the mediastinal mass measured 12.7 cm and had heterogeneous low-density areas. A submucosal gastric tumor, which we suspected to be a GIST, was diagnosed in association with an esophageal hiatal hernia. Using thoracolaparotomy, we performed a total gastrectomy, a lower esophagectomy, and a Roux-en-Y reconstruction with the jejunum. The presumptive diagnosis was confirmed through immunohistochemical examination; immunostaining yielded results positive for CD34 and c-kit. The patient was discharged from the hospital 13 days after surgery with no complications and remained disease-free at follow-up 24 months after surgery. CONCLUSIONS: GIST should be considered in the differential diagnosis of tumors growing in the mediastinum. Springer Berlin Heidelberg 2018-12-13 /pmc/articles/PMC6292835/ /pubmed/30547235 http://dx.doi.org/10.1186/s40792-018-0553-x Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Case Report
Fujisawa, Ryosuke
Akiyama, Yuji
Iwaya, Takeshi
Endo, Fumitaka
Nikai, Haruka
Baba, Shigeaki
Chiba, Takehiro
Kimura, Toshimoto
Takahara, Takeshi
Otsuka, Koki
Nitta, Hiroyuki
Mizuno, Masaru
Koeda, Keisuke
Sasaki, Akira
Giant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort: a case report
title Giant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort: a case report
title_full Giant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort: a case report
title_fullStr Giant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort: a case report
title_full_unstemmed Giant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort: a case report
title_short Giant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort: a case report
title_sort giant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6292835/
https://www.ncbi.nlm.nih.gov/pubmed/30547235
http://dx.doi.org/10.1186/s40792-018-0553-x
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