A Case of Extraluminal Gastrointestinal Stromal Tumor arising from Sigmoid Colon diagnosed as Diverticulitis

Shinnosuke Uegami, Yuji Imamura, Atsushi Nakamitsu, Mohei Kohyama, Aki Kuwada, Kunio Toge, Naoto Hadano, Hiroyuki Taogoshi and Yutaka Daimaru*

Department of Surgery and Department of Pathology*, JA Hiroshima General Hospital

We report an extremely rare case of extraluminal GIST resembling diverticulitis due to tumor necrosis. A 74-year-old-woman seen for 1 month of lower left abdominal pain was found in blood tests to have an elevated inflammatory response. Abdominal ultrasonography showed a tumor-like low echoic mass in the sigmoid colon. Computed tomography (CT) showed sigmoid colon enlargement and wall thickening, with surrounding fatty tissue density elevation. Colonoscopy detected easily bleeding hole like as diverticulum of the sigmoid colon, suggesting diverticulitis with an intraabdominal abscess. Based on this diagnosis, we conducted hand-assisted laparoscopic surgery (HALS). Operative findings showed a hard smooth-surfaced mass protruding from the sigmoid colon wall and adhering to the retroperitoneum, necessitating sigmoidectomy with partial retroperitoneal excision. The histopathological diagnosis was gastrointestinal stromal tumor (GIST). The postoperative course was uneventful and the woman is doing well without recurrence 12 months after surgery.

Key words
extraluminal GIST, colon, hand-assisted laparoscopic surgery

Reprint requests
Shinnosuke Uegami Department of Surgery, JA Hiroshima General Hospital
1-3-3 Jigozen, Hatsukaichi, 738-8503 JAPAN

Accepted
January 27, 2010

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