A Case of Huge Gastrointestinal Stromal Tumor and Thecoma with Massive Bloody Ascites

Yukihiro Itabashi^{1) 2)}, Shinsaku Suzuki¹⁾, Shinichi Sato¹⁾, Michihiko Asano¹⁾ and Mutsuo Sasaki²⁾

Department of Surgery, Yonaizawa Public General Hospital¹⁾
Department of Second Surgery, Hirosaki University school of medicine²⁾

An 82-year-old woman who was pointed out an abnormal shadow of the stomach by upper gastrointestinal series at a gastric cancer screening was diagnosed to have a submucosal tumor of the stomach and cholecystolithiasis. At surgery, a 11 cm tumor growing extraluminally from the anterior wall of the cardia and a hard right ovarian tumor with massive bloody ascites was observed. Total gastrectomy, cholecystectomy and right oophorectomy were performed. Immunohistochemical study showed that the gastric tumor was negative for myogenic and neurogenic markers, but was positive for CD34 and vimentin. From these observations, the gastric tumor was suspected to be gastrointestinal stromal tumor (GIST) with low malignant potential. The ovarian tumor was diagnosed as thecoma by Sudan stain and silver impregnation method. We suspected that the massive bloody ascites was due to thecoma and rupture of the GIST with bleeding. The postoperative course was uneventful and she had no sign of recurrence for three years.

Key words
gastrointestinal stromal tumor, thecoma of the ovary, bloody ascites

Reprint requests
Yukihiro Itabashi Department of Second Surgery, Hirosaki University School of Medicine 5 zaifu-cho, Hirosaki, 036-8562 JAPAN

Accepted
November 30, 1999

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