Hemothorax due to a ruptured esophageal gastrointestinal stromal tumor: case report

Abstract Background Esophageal gastrointestinal stromal tumors (GISTs) are rare tumors of the gastrointestinal interstitium, and comprise less than 0.7% of all GISTs. The presentation of esophageal GIST is relatively benign, commonly characterized by symptoms of dysphagia and gastrointestinal bleed....

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Main Authors: Shohei Ohki, Naoki Enomoto, Daiki Kato, Shusuke Yagi, Hitomi Wake, Kyoko Nohara, Hideki Miyazaki, Toru Igari, Norihiro Kokudo, Kazuhiko Yamada
Format: Article
Language:English
Published: Japan Surgical Society 2022-08-01
Series:Surgical Case Reports
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Online Access:https://doi.org/10.1186/s40792-022-01481-y
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author Shohei Ohki
Naoki Enomoto
Daiki Kato
Shusuke Yagi
Hitomi Wake
Kyoko Nohara
Hideki Miyazaki
Toru Igari
Norihiro Kokudo
Kazuhiko Yamada
author_facet Shohei Ohki
Naoki Enomoto
Daiki Kato
Shusuke Yagi
Hitomi Wake
Kyoko Nohara
Hideki Miyazaki
Toru Igari
Norihiro Kokudo
Kazuhiko Yamada
author_sort Shohei Ohki
collection DOAJ
description Abstract Background Esophageal gastrointestinal stromal tumors (GISTs) are rare tumors of the gastrointestinal interstitium, and comprise less than 0.7% of all GISTs. The presentation of esophageal GIST is relatively benign, commonly characterized by symptoms of dysphagia and gastrointestinal bleed. On the contrary, it is highly unusual for these tumors to present as surgical emergencies. Case presentation Here, we describe a case of hemothorax secondary to the rupture of a massive (19 cm) esophageal GIST in a 79-year-old male. The patient presented with mild back pain, vomiting, and hypotension. A CT scan revealed significant mediastinal enlargement and left hemothorax. We conducted an emergency thoracotomy which revealed a 19 × 15 × 7 cm ruptured esophageal tumor that was bleeding profusely into the left thoracic cavity. Piecemeal resection without esophagectomy was performed to achieve hemostasis. Pathological evaluation of resected tissue confirmed the diagnosis of GIST. The patient was provided adjuvant imatinib therapy and remains progression-free at the 10-month follow-up. Conclusions To the best of our knowledge, this is the first reported case of life-threatening hemothorax caused by a ruptured esophageal GIST. Findings from this case may aid in the diagnosis and management of these rare tumors.
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spelling doaj-art-ce0e7cc4e7a540ff87167663fcde5eab2025-08-20T03:57:44ZengJapan Surgical SocietySurgical Case Reports2198-77932022-08-01811510.1186/s40792-022-01481-yHemothorax due to a ruptured esophageal gastrointestinal stromal tumor: case reportShohei Ohki0Naoki Enomoto1Daiki Kato2Shusuke Yagi3Hitomi Wake4Kyoko Nohara5Hideki Miyazaki6Toru Igari7Norihiro Kokudo8Kazuhiko Yamada9Department of Surgery, Center Hospital of the National Center for Global Health and MedicineDepartment of Surgery, Center Hospital of the National Center for Global Health and MedicineDepartment of Surgery, Center Hospital of the National Center for Global Health and MedicineDepartment of Surgery, Center Hospital of the National Center for Global Health and MedicineDepartment of Surgery, Center Hospital of the National Center for Global Health and MedicineDepartment of Surgery, Center Hospital of the National Center for Global Health and MedicineDepartment of Pathology, Center Hospital of the National Center for Global Health and MedicineDepartment of Pathology, Center Hospital of the National Center for Global Health and MedicineDepartment of Surgery, Center Hospital of the National Center for Global Health and MedicineDepartment of Surgery, Center Hospital of the National Center for Global Health and MedicineAbstract Background Esophageal gastrointestinal stromal tumors (GISTs) are rare tumors of the gastrointestinal interstitium, and comprise less than 0.7% of all GISTs. The presentation of esophageal GIST is relatively benign, commonly characterized by symptoms of dysphagia and gastrointestinal bleed. On the contrary, it is highly unusual for these tumors to present as surgical emergencies. Case presentation Here, we describe a case of hemothorax secondary to the rupture of a massive (19 cm) esophageal GIST in a 79-year-old male. The patient presented with mild back pain, vomiting, and hypotension. A CT scan revealed significant mediastinal enlargement and left hemothorax. We conducted an emergency thoracotomy which revealed a 19 × 15 × 7 cm ruptured esophageal tumor that was bleeding profusely into the left thoracic cavity. Piecemeal resection without esophagectomy was performed to achieve hemostasis. Pathological evaluation of resected tissue confirmed the diagnosis of GIST. The patient was provided adjuvant imatinib therapy and remains progression-free at the 10-month follow-up. Conclusions To the best of our knowledge, this is the first reported case of life-threatening hemothorax caused by a ruptured esophageal GIST. Findings from this case may aid in the diagnosis and management of these rare tumors.https://doi.org/10.1186/s40792-022-01481-yEsophageal gastrointestinal stromal tumorGISTHemothoraxPosterior mediastinal tumorTumor rupture
spellingShingle Shohei Ohki
Naoki Enomoto
Daiki Kato
Shusuke Yagi
Hitomi Wake
Kyoko Nohara
Hideki Miyazaki
Toru Igari
Norihiro Kokudo
Kazuhiko Yamada
Hemothorax due to a ruptured esophageal gastrointestinal stromal tumor: case report
Surgical Case Reports
Esophageal gastrointestinal stromal tumor
GIST
Hemothorax
Posterior mediastinal tumor
Tumor rupture
title Hemothorax due to a ruptured esophageal gastrointestinal stromal tumor: case report
title_full Hemothorax due to a ruptured esophageal gastrointestinal stromal tumor: case report
title_fullStr Hemothorax due to a ruptured esophageal gastrointestinal stromal tumor: case report
title_full_unstemmed Hemothorax due to a ruptured esophageal gastrointestinal stromal tumor: case report
title_short Hemothorax due to a ruptured esophageal gastrointestinal stromal tumor: case report
title_sort hemothorax due to a ruptured esophageal gastrointestinal stromal tumor case report
topic Esophageal gastrointestinal stromal tumor
GIST
Hemothorax
Posterior mediastinal tumor
Tumor rupture
url https://doi.org/10.1186/s40792-022-01481-y
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