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Pancreatic Gastrointestinal Stromal Tumor after Upper Gastrointestinal Hemorrhage and Performance of Whipple Procedure: A Case Report and Literature Review

Challenging differential diagnosis, Unusual or unexpected effect of treatment, Rare disease

Mehmet Aziret, Süleyman Çetinkünar, Elife Aktaş, Oktay İrkörücü, İlhan Bali, Hasan Erdem

(Department of General Surgery, Kars State Hospital, Kars, Turkey)

Am J Case Rep 2015; 16:509-513

DOI: 10.12659/AJCR.893803

Published: 2015-08-03

BACKGROUND: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal system. These types of tumors originate from any part of the tract as well as from the intestine, colon, omentum, mesentery or retroperitoneum. GIST is a rare tumor compared to other types of tumors, accounting for less than 1% of all gastrointestinal tumors.
CASE REPORT: A 56-year-old male patient was hospitalized due to an upper gastrointestinal hemorrhage and the start of abdominal pain on the same day. In the upper gastrointestinal endoscopy that was performed, a solitary mass was found in the second section of the duodenum and a blood vessel (Forrest type 2a) was seen. The extent and location of the mass was detected by abdominal tomography. After hemodynamic recovery, a Whipple procedure was performed without any complications. A subsequent histopathological examination detected a c-kit-positive (CD117) pancreatic GIST with high mitotic index.
CONCLUSIONS: The most effective treatment method for GISTs is surgical resection. In patients with a head of pancreatic GIST, the Whipple procedure can be used more safely and effectively.

Keywords: Gastrointestinal Hemorrhage - etiology, Duodenal Neoplasms - surgery, Gastrointestinal Stromal Tumors - surgery, Humans, Male, Middle Aged, Pancreatic Neoplasms - surgery, Pancreaticoduodenectomy