Korean J Gastroenterol.  2018 Oct;72(4):205-208. 10.4166/kjg.2018.72.4.205.

A Ruptured Metastatic Hepatic Gastrointestinal Stromal Tumor Treated by Angiographic Embolization

• Jang SJ
• Kwon JH
• Han Y

• KMID: 2424112
• DOI: http://doi.org/10.4166/kjg.2018.72.4.205

Abstract

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumor of the gastrointestinal tract and occur most frequently in the stomach. The liver is the most common metastatic site of a GIST, and spontaneous rupture of the hepatic metastasis of a malignant gastric GIST is rare. We report the case of a 70-year-old man who presented with sudden right lower quadrant abdominal pain and was diagnosed with a spontaneously ruptured hepatic metastasis of a malignant gastric GIST. The patient was successfully managed with transcatheter arterial embolization of the hepatic artery.

Keyword

Embolization, therapeutic; Hemorrhage; Gastrointestinal stromal tumors; Liver; Rupture

MeSH Terms

Abdominal Pain
Aged
Embolization, Therapeutic
Gastrointestinal Stromal Tumors*
Gastrointestinal Tract
Hemorrhage
Hepatic Artery
Humans
Liver
Neoplasm Metastasis
Rupture
Rupture, Spontaneous
Stomach

Figure

• 

  Fig. 1 Contrast-enhanced abdominal CT image of a 70-year-old man with spontaneous rupture of a hepatic metastasis from a gastric GIST. Axial (A) and coronal (B) CT images show a round-shaped, low-density mass (asterisk) in the inferior angle of the liver. This metastatic lesion located in the subcapsular area shows an irregular and broken inferior-medial margin (long arrows) of the metastatic lesion, suggesting rupture. Hemoperitoneum is noted in the subhepatic (short arrows) and subphrenic spaces (empty arrows). CT, computed tomography; GIST, gastrointestinal stromal tumor.

• 

  Fig. 2 Angiography of the common hepatic artery of a 70-year-old man. (A) Angiography of the common hepatic artery shows a round-shaped, hypervascular mass (short arrows) in the inferior angle of the liver supplied by the posterior-inferior segmental hepatic artery (empty arrows). (B) Post-embolization angiography of the common hepatic artery revealed a disappeared and obstructed hypervascular mass (short arrows) supplying the hepatic artery.

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