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A case of diffuse infiltrating gastrointestinal stromal tumor of sigmoid colon with perforation
Author(s) -
Yamashita Daisuke,
Usami Yu,
Toyosawa Satoru,
Hirota Seiichi,
Imai Yukihiro
Publication year - 2014
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/pin.12124
Subject(s) - gist , medicine , perforation , lesion , stromal tumor , pathology , sigmoid colon , gastrointestinal tract , muscularis mucosae , radiology , stromal cell , surgery , rectum , materials science , punching , metallurgy
Gastrointestinal stromal tumors ( GIST s) are the most common mesenchymal neoplasms of the gastrointestinal tract, and typically present as discrete well‐circumscribed but non‐encapsulated tumor masses. In this report, we describe a case of colonic perforation caused by an unusual form of GIST . A 72‐year‐old J apanese woman presented to the emergency department with acute abdominal pain. Under the provisional diagnosis of sigmoid colon perforation, a laparoscopic sigmoidectomy was performed. Although the tumor mass was undetectable during the preoperative examination, a spindle cell lesion with a diffuse longitudinal growth pattern replacing the muscularis propria was revealed by microscopic examination. The spindle cell lesion was exposed at the perforation, suggesting a causal relationship between the lesion and the perforation. The spindle cell lesion was KIT ‐positive and had a mutation in the C ‐ KIT gene at exon 11. We diagnosed it as diffuse infiltrating GIST . We consider that the lesion would be a cause of the colonic perforation, and emphasize the importance of accurate diagnosis of the lesion by histological, immunohistochemical and genetic examinations.