Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 6, 2023; 11(28): 6797-6805
Published online Oct 6, 2023. doi: 10.12998/wjcc.v11.i28.6797
Rare rectal gastrointestinal stromal tumor case: A case report and review of the literature
Ruo-Xi Dong, Chen Wang, Hao Zhou, Hao-Qiang Yin, Yang Liu, Hong-Tao Liang, Yi-Bin Pan, Jia-Wen Wang, Yong-Qing Cao
Ruo-Xi Dong, Chen Wang, Hao Zhou, Yang Liu, Hong-Tao Liang, Yi-Bin Pan, Jia-Wen Wang, Yong-Qing Cao, Department of Anorectal Surgery, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
Ruo-Xi Dong, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
Hao-Qiang Yin, Department of Ultrasound, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
Author contributions: Dong RX and Zhou H collected data and drafted the manuscript; Yin HQ provide the transrectal ultrasound and ultrasonic contrast pictures; Liu Y, Pan YB, Wang JW, and Liang HT analyzed the case materials; Wang C and Cao YQ have reviewed the manuscript; all authors have made substantial contributions to the work, and all authors have read and approved the final manuscript.
Supported by National Nature Science Foundation of China, No. 82004374; the second round of construction project for the National Traditional Chinese Medicine Academic School Inheritance Studio; the three-year action project for Shanghai to further accelerate the inheritance innovation and development of traditional Chinese medicine, No. ZY[2021-2023]-0209; and Shanghai "Rising Stars of Medical Talents" Youth Development Program, Youth Medical Talents–Specialist Program, No. [2021]-099.
Informed consent statement: Informed consent was obtained from the patient for publication of the case and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Chen Wang, MD, Chief Physician, Director, Professor, Surgeon, Department of Anorectal Surgery, LongHua Hospital, Shanghai University of Traditional Chinese Medicine, No. 725 South Wanping Road, Xuhui district, Shanghai 200032, China. wangchen_longhua@163.com
Received: July 22, 2023
Peer-review started: July 22, 2023
First decision: August 9, 2023
Revised: August 18, 2023
Accepted: September 4, 2023
Article in press: September 4, 2023
Published online: October 6, 2023
Abstract
BACKGROUND

Gastrointestinal stromal tumors (GISTs) are rare tumors of the gastrointestinal tract accounting for less than 1% of all gut tumors. GISTs occurring in the rectum are extremely rare, and these usually present at an advanced stage compared with other sites.

CASE SUMMARY

A 60-year-old male who presented with features of sensations of rectal tenesmus was referred to our department with a mass in the lower rectum that was detected during a routine checkup. Colonoscopy, transrectal ultrasound, perianal magnetic resonance imaging and ultrasonic contrast were used to diagnose the rectum GIST, and then the patient underwent complete transanal resection using the ultrasonic scalpel. The patient was discharged ten days after the operation and was defined as low risk. Therefore, he had no need to receive subsequent adjuvant therapies, and he had not suffered any anal dysfunction or had any evidence of recurrence at follow up.

CONCLUSION

Surgical resection with histologically negative margins is the standard curative treatment for rectal GISTs. Appropriate surgical techniques based on the location, size, and resectability of the tumor should attract great attention from clinicians.

Keywords: Gastrointestinal stromal tumor, Rectum, Ultrasonic scalpel resection, Case report

Core Tip: Gastrointestinal stromal tumors are rare malignancies that rarely occur in the rectum. The diagnosis is established by biopsy and immunohistochemistry. Complete surgical resection with negative margins is the treatment of choice. The appropriate surgical technique should be selected based on the location, size, and resectability of the tumor and the available surgical expertise. This case is reported for its rare location and treatment with ultrasonic scalpel total resection without imatinib treatment.