Two Cases of Malignant Gastrointestinal Stromal Tumor of Small Intestine Causing Gastrointestinal Bleeding

Tomoki Tsuda¹⁾²⁾, Hiroyuki Wakiyama²⁾, Kazushige Okada²⁾, Tiyuki Watanabe²⁾ and Susumu Matsukuma³⁾

Department of Surgery, Self Defense Force Kumamoto Hospital¹⁾
Department of Surgery²⁾ and Department of Pathology³⁾, Self Defense Force Central Hospital

We report two cases of small intestinal GIST causing gastrointestinal bleeding. Case 1: An 80-year-old man presented with tarry stools. A barium roentogenography and abdominal CT examination revealed a submucosal tumor in the jejunum, 10 cm away from Treitz's ligament. We suspected that the tumor was causing gastrointestinal bleeding and operated. The histopathological diagnosis of the tumor was a low-grade malignant GIST; immunohistochemically, a tendency toward smooth muscle cell differentiation was observed. Case 2: A 73-year-old man presented with melena. An abdominal CT revealed an encapsulated tumor connecting with the small intestinal wall. A gastrointestinal scintigram demonstrated bleeding in the small intestine, and surgery was performed. A histopathological diagnosis of malignant GIST was made; immunohistochemically, a tendency toward neural cell differentiation was observed. Only 9 cases of small intestinal GIST have been reported in the Japanese literature, including the present cases. Of these 9 cases, 6 were malignant or suspected to be malignant. Small intestinal GIST should be recognized as a high risk group of malignancy requiring careful follow-up after operation.

Key words
gastrointestinal stromal tumor, small intestine, malignant

Reprint requests
Tomoki Tsuda Department of Surgery, Self Defense Force Kumamoto Hospital 15-1 Higashihonmati, Kumamoto, 862-0902 JAPAN

Accepted
September 19, 2001

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