Open AccessA Rare Case of Three Distinct Gastrointestinal Neoplasms Occurring Simultaneously in an Elderly Patient
Author(s) -
Saad Hanan,
Enkhmaa Luvsannyam,
Molly S Jain,
Srishti Laller,
Tayyab Cheema,
Cory Mellon,
Don N. Teed,
Manoj Reddy Somagutta,
Laila N. Ahmad,
Frederick Tiesenga
Publication year - 2021
Publication title -
journal of medical cases
Language(s) - English
Resource type - Journals
eISSN - 1923-4163
pISSN - 1923-4155
DOI - 10.14740/jmc3765
Subject(s) - medicine , gist , anemia , abdominal pain , duodenal bulb , stromal tumor , pancreas , abdomen , gastrointestinal bleeding , radiology , colonoscopy , gastroenterology , cancer , colorectal cancer , duodenum , stromal cell
Duodenal adenocarcinoma (DA), gastrointestinal stromal tumor (GIST), and pancreatic neuroendocrine tumor (PNET) are a set of rare gastrointestinal (GI) cancers characterized by nonspecific symptoms such as anemia, weight loss, and abdominal pain. We report an interesting case of DA, GIST, and PNET in a 79-year-old African American male who presented to the emergency department with syncope. The patient was tachycardic and found to have severe anemia. Further computed tomography (CT) of the abdomen and pelvis with contrast revealed a mass within the duodenal bulb along with a pancreatic cystic lesion. The patient underwent gastroduodenectomy and distal pancreatectomy with incidental findings of GIST in the posterior gastric wall. The patient after surgical removal of all tumors no longer experienced abdominal pain and had hematocrit and hemoglobin (H&H) level of 9.1/31.7 postoperation day (POD) 14. The case unfolds a rare presentation of three neoplasms that were moderate to well-differentiated with no metastases. It highlights the importance of assessment of rare GI neoplasms concurrently with colorectal cancer when geriatric patients present with nonspecific GI symptoms.