A case of diffuse infiltrating gastrointestinal stromal tumor of sigmoid colon with perforation

作者：Yamashita Daisuke; Usami Yu; Toyosawa Satoru; Hirota Seiichi; Imai Yukihiro^*

来源：Pathology International, 2014, 64(1): 34-38.

DOI：10.1111/pin.12124

• acute abdomen
• acute peritonitis
• gastrointestinal neoplasia
• GIST

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract, and typically present as discrete well-circumscribed but non-encapsulated tumor masses. In this report, we describe a case of colonic perforation caused by an unusual form of GIST. A 72-year-old Japanese woman presented to the emergency department with acute abdominal pain. Under the provisional diagnosis of sigmoid colon perforation, a laparoscopic sigmoidectomy was performed. Although the tumor mass was undetectable during the preoperative examination, a spindle cell lesion with a diffuse longitudinal growth pattern replacing the muscularis propria was revealed by microscopic examination. The spindle cell lesion was exposed at the perforation, suggesting a causal relationship between the lesion and the perforation. The spindle cell lesion was KIT-positive and had a mutation in the C-KIT gene at exon 11. We diagnosed it as diffuse infiltrating GIST. We consider that the lesion would be a cause of the colonic perforation, and emphasize the importance of accurate diagnosis of the lesion by histological, immunohistochemical and genetic examinations.

• 出版日期2014-1