Korean J Gastroenterol.  2012 May;59(5):372-376. 10.4166/kjg.2012.59.5.372.

Gastroduodenal Intussusception Due to Pedunculated Polypoid Gastrointestinal Stromal Tumor

• Seok HS
• Shon CI
• Seo HI
• Choi YG
• Chung WG
• Won HS

• KMID: 1792837
• DOI: http://doi.org/10.4166/kjg.2012.59.5.372

Abstract

The gastrointestinal stromal tumor (GIST) is a mesenchymal tumor of the digestive tract showing differentiation along the line of interstitial cell of Cajal. The most GISTs in the stomach generally show the appearance of submucosal tumors. It is rare for GISTs to appear as a pedunculated polypoid lesion on endoscopy. We experienced a case of a 51-year-old man who had a pedunculated polypoid GIST. He was admitted to our hospital for nausea, vomiting, melena and severe anemia (hemoglobin 3.4 g/dL, hematocrit 10.8%). An upper endoscopy showed gastroduodenal intussusception due to a pedunculated polypoid mass. This report presents a rare case of endoscopically proven gastroduodenal intussusceptions due to pedunculated polypoid GIST in the stomach.

Keyword

Gastrointestinal stromal tumors; Polyps; Intussusception

MeSH Terms

Duodenal Diseases/etiology/*pathology
Gastrointestinal Hemorrhage
Gastrointestinal Neoplasms/complications/*pathology
Gastrointestinal Stromal Tumors/complications/*pathology
Gastroscopy
Humans
Intussusception/etiology/*pathology
Male
Middle Aged
Tomography, X-Ray Computed

Figure

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  Fig. 1 An endoscopic finding. (A) Endoscopy showed abnormal convergence of the gastric folds from antrum toward the pylorus, suggesting intussuception in the duodenum. (B) The surface of mass was hemorrhagic and showed uneven granular appearance on the retroflexed view in the duodenal 2nd portion.

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  Fig. 2 Abdominal CT finding. (A) Abdominal CT scan showed full thickeness invagination of the proximal antrum with the omentum in the duodenum. pA, proximal antrum; dA, distal antrum; O, omentum; P, pyloric ring; D, duodenum. (B) It showed intussuscepted heterogenous low density mass into the 2nd portion of the duodenum and no regional lymph node enlargement.

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  Fig. 3 Gross findings of resected specimen. The resected tumor was 5.5×4.2×1.7 cm in size. The mass showed brownish granular apperance with hemorrhage.

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  Fig. 4 Histopathologic findings (×400). (A) The tumor cells was composed of epithelioid cells with mitosis (H&E). The tumor cells was positive for CD 117 (B) and CD34 (C).

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