Abstract
A Case Report on Rectal Gastrointestinal Stromal Tumor
Danica H. Sanchez, M.D., James Crisfil Fructuoso M. Montesa, M.D., Jan Paola B. Frayna, M.D.
Section of Gastroenterology and Digestive Endoscopy, Manila Doctors Hospital
Clinical Presentation: GIST located in the rectum is uncommon and usually accounts to less than 5% of cases. They are usually found incidentally and may mimic a rectal adenocarcinoma hence diagnosis is challenging. Biopsy may impose risks but sometimes may be performed in cases of unresectable GIST to establish diagnosis and initiation of systemic therapy. This paper presents a case of a 35-year-old male who presented with decreased stool caliber, hematochezia and a mass at the right gluteal area. The patient underwent colonoscopy which revealed a submucosal mass at the rectum with biopsy taken. MRI of the whole abdomen with rectal protocol showed a heterogeneously enhancing well-circumscribed solid lobulated exophytic mass exophytic mass involving the mid to lower rectum traversing its anterior wall measuring 9.3 x7.6 x 16.8 cm. Final histopathology report showed spindle cell neoplasm with high grade mitotic rate of >5 per 5mm2 and immunohistochemistry result positive for CD 117, CD 34, S100, DOG-1 and H-Caldesmon which were consistent with GIST. This paper further reviews the histopathologic and immunohistochemistry findings of GIST and its correlation with determining the prognosis among these patients. Due to the findings and size of the mass, patient was started on Imatinib 400mg, one tablet once a day and was closely monitored for reassessment for possible surgical approach.
Keywords: Gastrointestinal Stromal Tumor, Case Report
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
| Hybrid Research Workshop 4 week asynchronous via Moodle, followed by a 1 day on-site Onsite Workshop Research Protocol Presentation for Level I GI Fellows-In-Training - Research Protocol Presentation: August 12, 2023 - Research Forums of the Tripartite Societies |
Week 1: July 15-21, 2023 Week 2: July 22-28, 2023 Week 3: July 29-August 4, 2023 Week 4: August 5-11, 2023 |
| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |