Giant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort: a case report
Abstract Background Gastrointestinal stromal tumors (GISTs) grow relatively slowly and without specific symptoms; therefore, they are typically incidental findings. We report a rare gastric GIST in the mediastinum associated with chest discomfort and an esophageal hiatal hernia. Case presentation An...
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Japan Surgical Society
2018-12-01
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| Series: | Surgical Case Reports |
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| Online Access: | http://link.springer.com/article/10.1186/s40792-018-0553-x |
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| author | Ryosuke Fujisawa Yuji Akiyama Takeshi Iwaya Fumitaka Endo Haruka Nikai Shigeaki Baba Takehiro Chiba Toshimoto Kimura Takeshi Takahara Koki Otsuka Hiroyuki Nitta Masaru Mizuno Keisuke Koeda Akira Sasaki |
| author_facet | Ryosuke Fujisawa Yuji Akiyama Takeshi Iwaya Fumitaka Endo Haruka Nikai Shigeaki Baba Takehiro Chiba Toshimoto Kimura Takeshi Takahara Koki Otsuka Hiroyuki Nitta Masaru Mizuno Keisuke Koeda Akira Sasaki |
| author_sort | Ryosuke Fujisawa |
| collection | DOAJ |
| description | Abstract Background Gastrointestinal stromal tumors (GISTs) grow relatively slowly and without specific symptoms; therefore, they are typically incidental findings. We report a rare gastric GIST in the mediastinum associated with chest discomfort and an esophageal hiatal hernia. Case presentation An 81-year-old woman with chest discomfort was admitted to the hospital, where barium esophagography showed a sliding esophageal hiatal hernia and a tumor of the lower esophagus and gastric wall. Esophagogastroscopy confirmed the presence of a huge submucosal tumor that extended from the lower esophagus to the gastric fundus. According to computed tomography, the mediastinal mass measured 12.7 cm and had heterogeneous low-density areas. A submucosal gastric tumor, which we suspected to be a GIST, was diagnosed in association with an esophageal hiatal hernia. Using thoracolaparotomy, we performed a total gastrectomy, a lower esophagectomy, and a Roux-en-Y reconstruction with the jejunum. The presumptive diagnosis was confirmed through immunohistochemical examination; immunostaining yielded results positive for CD34 and c-kit. The patient was discharged from the hospital 13 days after surgery with no complications and remained disease-free at follow-up 24 months after surgery. Conclusions GIST should be considered in the differential diagnosis of tumors growing in the mediastinum. |
| format | Article |
| id | doaj-art-e855ea8a24264aacb08c7fc901737731 |
| institution | DOAJ |
| issn | 2198-7793 |
| language | English |
| publishDate | 2018-12-01 |
| publisher | Japan Surgical Society |
| record_format | Article |
| series | Surgical Case Reports |
| spelling | doaj-art-e855ea8a24264aacb08c7fc9017377312025-08-20T03:19:10ZengJapan Surgical SocietySurgical Case Reports2198-77932018-12-01411710.1186/s40792-018-0553-xGiant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort: a case reportRyosuke Fujisawa0Yuji Akiyama1Takeshi Iwaya2Fumitaka Endo3Haruka Nikai4Shigeaki Baba5Takehiro Chiba6Toshimoto Kimura7Takeshi Takahara8Koki Otsuka9Hiroyuki Nitta10Masaru Mizuno11Keisuke Koeda12Akira Sasaki13Department of Surgery, Iwate Medical University School of MedicineDepartment of Surgery, Iwate Medical University School of MedicineDepartment of Surgery, Iwate Medical University School of MedicineDepartment of Surgery, Iwate Medical University School of MedicineDepartment of Surgery, Iwate Medical University School of MedicineDepartment of Surgery, Iwate Medical University School of MedicineDepartment of Surgery, Iwate Medical University School of MedicineDepartment of Surgery, Iwate Medical University School of MedicineDepartment of Surgery, Iwate Medical University School of MedicineDepartment of Surgery, Iwate Medical University School of MedicineDepartment of Surgery, Iwate Medical University School of MedicineDepartment of Surgery, Iwate Medical University School of MedicineDepartment of Medical Safety Science, Iwate Medical University School of MedicineDepartment of Surgery, Iwate Medical University School of MedicineAbstract Background Gastrointestinal stromal tumors (GISTs) grow relatively slowly and without specific symptoms; therefore, they are typically incidental findings. We report a rare gastric GIST in the mediastinum associated with chest discomfort and an esophageal hiatal hernia. Case presentation An 81-year-old woman with chest discomfort was admitted to the hospital, where barium esophagography showed a sliding esophageal hiatal hernia and a tumor of the lower esophagus and gastric wall. Esophagogastroscopy confirmed the presence of a huge submucosal tumor that extended from the lower esophagus to the gastric fundus. According to computed tomography, the mediastinal mass measured 12.7 cm and had heterogeneous low-density areas. A submucosal gastric tumor, which we suspected to be a GIST, was diagnosed in association with an esophageal hiatal hernia. Using thoracolaparotomy, we performed a total gastrectomy, a lower esophagectomy, and a Roux-en-Y reconstruction with the jejunum. The presumptive diagnosis was confirmed through immunohistochemical examination; immunostaining yielded results positive for CD34 and c-kit. The patient was discharged from the hospital 13 days after surgery with no complications and remained disease-free at follow-up 24 months after surgery. Conclusions GIST should be considered in the differential diagnosis of tumors growing in the mediastinum.http://link.springer.com/article/10.1186/s40792-018-0553-xGastric gastrointestinal stromal tumorGiant gastrointestinal stromal tumorMediastinal tumorHiatal hernia |
| spellingShingle | Ryosuke Fujisawa Yuji Akiyama Takeshi Iwaya Fumitaka Endo Haruka Nikai Shigeaki Baba Takehiro Chiba Toshimoto Kimura Takeshi Takahara Koki Otsuka Hiroyuki Nitta Masaru Mizuno Keisuke Koeda Akira Sasaki Giant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort: a case report Surgical Case Reports Gastric gastrointestinal stromal tumor Giant gastrointestinal stromal tumor Mediastinal tumor Hiatal hernia |
| title | Giant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort: a case report |
| title_full | Giant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort: a case report |
| title_fullStr | Giant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort: a case report |
| title_full_unstemmed | Giant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort: a case report |
| title_short | Giant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort: a case report |
| title_sort | giant gastrointestinal stromal tumor of the mediastinum associated with an esophageal hiatal hernia and chest discomfort a case report |
| topic | Gastric gastrointestinal stromal tumor Giant gastrointestinal stromal tumor Mediastinal tumor Hiatal hernia |
| url | http://link.springer.com/article/10.1186/s40792-018-0553-x |
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