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A Journal on Surgery
Indexed/Abstracted in: EMBASE, Scopus, Emerging Sources Citation Index
Chirurgia 2008 February;21(1):45-7
Gastric gastrointestinal stromal tumor presenting as a pancreatic pseudocyst
Busic´ Zˇ., D. Servis, Stipancic´ I., Busic´ V.
Department for Abdominal Surgery University Hospital “Dubrava” Zagreb, Croatia
Gastrointestinal stromal tumors are a heterogenous group of tumors that arise from the wall of gastrointestinal tract. They are mesenchymal, solid tumors that are histochemically positive for CD34 and CD117 markers. We present a case where a patient was diagnosed with pancreatic pseudocyst. The pseudocyst was surgically drained using Roux-en-Y jejunal limb, with patohistological examination of pseudocyst wall indicating fibrosis and inflammation. Seven months later the same patient was diagnosed with gastrointestinal stromal tumor in the same location as the pseudocyst, arising from the posterior gastric wall.
The tumor was surgically removed, but intraoperatively the jejunal limb placed in the first operation to drain the pseudocyst was found leading directly into the tumor. Since the pancreas was not infiltrated by the tumor, and taking into account similar gastroscopic, ultrasound and CAT scan findings in the diagnosis of both pseudocyst and tumor.
The pseudocyst was formed by the tumor, and only after its drainage did the tumor appear in the solid form. Immunohistoche-mically, tumor was diagnosed as a GIST, its cells being CD117- and CD34-positive. Thus we report, to our knowledge, the first case of a pseudocystic form of a gastrointestinal stromal tumor.