A Case of Gastrointestinal Stromal Tumor of the Duodenum

Yasushi Wada, Shinobu Tsuchida, Satoshi Yamanouchi, Satoshi Kumada, Shun Sato, Masao Shinoda, Shinya Kawaguchi, Michio Abe, Shigeyuki Asano^* and Fumiaki Shinya

Department of Surgery, and Department of Pathology^*, Iwaki Kyoritsu General Hospital

A 57-year-old man visitted to our hospital because of tarry stool, nausea and epigastralgia. Emergency upper gastrointestinal endoscopic examination detected a submucosal tumor with a hemorrhagic ulcer at the third portion of the duodenum. Abdominal computed tomography showed that the tumor was 5 cm in diameter, solid with a well-delineated border. On abdominal angiography, the tumor had hypervascularity. Leiomyoma or leiomyosarcoma of the duodenum was suspected preoperatively, and a partial resection of the duodenum was performed. Histopathologically, the tumor was composed of proliferated spindle cells which had mitotic figures by 2-3/10 high power field. Immunohistological examination revealed that the tumor was positive for S-100 protein, CD34 and KIT, and partially positive for SMA. Therefore, this tumor was diagnosed as combined smooth muscle neural type of GIST, originated from interstitial cells of Cajal.

Key words
gastrointestinal stromal tumor, c-kit, CD34

Reprint requests
Yasushi Wada Obihiro Daiichi Hospital 17-3, W-4, S-15, Obihiro, 080-0014 JAPAN

Accepted
January 30, 2002

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