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A Journal on Surgery

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Chirurgia 2004 February;17(1):31-4

language: Italian

A case of gastrointestinal stromal juxtacardiac tumor extending into the esophagus occurred on a nissen fundoplication after 18 years

Cecere C., Cicalese M., Maietta P., Galzerano S., De Rosa P.


Gastrointestinal stromal tumor (GIST) of the stomach extending into the posterior mediastinum is rare. A case of GIST of the esophagogastric junction developed in a 62-year-old woman is described. Eighteen years prior to the diagnosis of GIST, the patient underwent a Nissen fundoplication for esophageal hiatal hernia. The woman was referred to us for moderate dyspnea and melena, relapsed after 10 months. CT scan, MRI, upper gastointestinal series and esophagogastroscopy were performed. A mass at the esophagogastric junction, 7 cm in diameter, was showed extending into the posterior mediastinum. Gastroscopy demonstrated a posterior ulcerating tumor of the proximal stomach, near the cardia, infiltranting the esophagogastric junction for 3 cm upward. Biopsy was positive for sarcoma. A left videothoracoscopy showed the resectability of the tumor. The patient underwent a thoracoabdominal esophagogastrectomy and a Roux-en-Y esophagojejunostomy. At 1-year postoperative follow-up the patient is in good state of health and without evidence of metastatic disease. The clinical, diagnostic, therapeutic and cytohistopathological aspects of this disease are discussed.

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