Case Report
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Sep 16, 2024; 12(26): 5990-5997
Published online Sep 16, 2024. doi: 10.12998/wjcc.v12.i26.5990
Extragastrointestinal stromal tumors with diffuse membranous distribution with bleeding: A case report
Jian-Duo Xu, Zheng Wang, Qian Zhou, Ning Meng, Shu-Mei Zhang, Nan Liu
Jian-Duo Xu, Department of Gastrointestinal Surgery, Shijiazhuang People’s Hospital, Shijiazhuang 050000, Hebei Province, China
Zheng Wang, Shu-Mei Zhang, Nan Liu, Department of Gastroenterology, Shijiazhuang People's Hospital, Shijiazhuang 050000, Hebei Province, China
Qian Zhou, Ning Meng, Department of General Surgery, Shijiazhuang People's Hospital, Shijiazhuang 050000, Hebei Province, China
Author contributions: Xu JD designed the research; Wang Z performed the research; Meng N, Zhou Q, Zhang SM, and Liu N analyzed the data and wrote the manuscript; all authors have read and approved the final manuscript.
Informed consent statement: All patients and healthy volunteers provided written informed consent prior to their inclusion in the study.
Conflict-of-interest statement: The authors declare no competing interests.
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: Zheng Wang, MD, Associate Chief Physician, Department of Gastroenterology, Shijiazhuang People's Hospital, No. 9 Fangbei Street, Shijiazhuang 050000, Hebei Province, China. wzcelia1983@163.com
Received: April 18, 2024
Revised: June 8, 2024
Accepted: July 3, 2024
Published online: September 16, 2024
Processing time: 95 Days and 16.6 Hours
Abstract
BACKGROUND

Extragastrointestinal stromal tumors (EGIST) and gastrointestinal stromal tumors are of similar pathological type and form. Here we report a rare case of EGIST diffusely distributed in membranous tissue in abdominal cavity, the feature of which included diffuse tumors at membranous tissue in entire abdominal cavity and spontaneous bleeding of the tumors.

CASE SUMMARY

The patient was a 71-year man and hospitalized due to continuous pain at lower abdomen for more than 10 days. Upon physical examination, the patient had flat and tough abdomen with mild pressing pain at lower abdomen, no obvious abdominal mass was touchable, and shifting dullness was positive. Positron emission tomography-computed tomography (CT) showed that in his peritoneal cavity, there were multiple nodules of various sizes, seroperitoneum, multiple enlarged lymph nodes in abdominal/pelvic cavity and right external ilium as well as pulmonary nodules. Plain CT scanning at epigastrium/hypogastrium/pelvic cavity + enhanced three-dimensional reconstruction revealed multiple soft tissue nodules in abdominal/pelvic cavity, peritoneum and right groin. Tumor marker of carbohydrate antigen 125 was 808 U/mL, diffuse tuberous tumor was seen in abdominal/pelvic cavity during operation with hematocelia, and postoperative pathological examination confirmed EGIST. Imatinib was administered with better therapeutic effect.

CONCLUSION

Gene testing showed breast cancer susceptibility gene 1 interacting protein C-terminal helicase 1 and KIT genovariation, and the patient was treated with imatinib follow-up visit found that his clinical symptoms disappeared and the tumor load alleviated obviously via imageological examination.

Keywords: Diffuse tumor in abdominal cavity; Extragastrointestinal stromal tumors; Gastrointestinal stromal tumors; Malignant extragastrointestinal stromal tumors; Diffusely membranous metastasis

Core Tip: Extragastrointestinal stromal tumors (EGIST) are less common in comparison with gastrointestinal stromal tumors. EGIST tumors in the membranous tissue are rare and tumors independently developing in membrane tissues such as greater omentum, mesentery or peritoneum are occasionally reported. Diffuse membranous tumor in entire abdominal cavity is extremely rare worldwide. We report a case of EGIST with the tumors like cobblestone being diffusely distributed in entire abdominal cavity accompanied by spontaneous bleeding. The tumors may not be fully resected by surgery, hence we made biopsy, pathological examination and gene detection to determine the therapy. Treatment with imatinib achieved better outcome.