Coexistence of multiple gastrointestinal stromal tumors and signet ring cell carcinoma of stomach in a patient with neurofibromatosis type-1: case report

Gastrointestinal stromal tumors are mesenchymal neoplasias which are derivedfrom Cajal's interstitial cells. The most common site of involvement is thestomach. It may be multiple in patients with Neurofibromatosis Type-1, while thesmall intestine is the most common location. In this case report, we aimed topresent a Neurofibromatosis Type-1 patient, showing coexistence of multiplegastrointestinal stromal tumors in the stomach and small intestine with a signetring cell carcinoma in the stomach. A 74-year-old female patient with poorappetite, vomiting and stomach ache was admitted to the hospital. Afterdetection of a tumoral lesion with an ulcerated surface in stomach during theupper gastrointestinal tract endoscopic examination, the patient underwentsurgery. During the operation, multiple nodular lesions were observed in theserosal surfaces of the small intestine and stomach. Gastrectomy and partialsmall intestine resection specimens were evaluated and the patient was diagnosedas signet ring cell carcinoma in the stomach, and multiple gastrointestinalstromal tumors in the serosal surfaces of both the stomach and small intestine.Resection specimens of patients with GIST need to be evaluated carefully onmacroscopic examination, considering the possible presence of a coexistenttumoral lesion.