Giant Esophageal GIST: Diagnostic and Therapeutic Challenge - Case Report
S. Constantinoiu, M. Gheorghe, L. Popa, C. Ciocea, C. Iosif, R. Tiutiuca, A. Iordache, I. CordoşImage Quiz for surgeons, no. 3, 2015
GIST are rare mesenchymal tumors of the digestive tract (lessthan 1% of the digestive tract neoplasia). Of these, less than 1% are found in the esophagus. Surgery is the main treatment of GIST and is supported by targeted therapy with tyrosinekinase inhibitors like imatinibmesylate. We present the case of a female patient of 51 years, admitted in our clinic for a bulkytumor in the posterior mediastinum, diagnosed after investigations performed for fatigue for the great efforts. Clinical examination was unspecific. Chest X-ray and thoraco-abdominal CT identified a widening of the mediastinum through aposterior mediastinal tumor mass, determining a deviation to the left of the thoracic esophagus without causing notabledysphagia or respiratory symptoms. It was decided surgery bythoracotomy in V right intercostal space and total excision ofthe tumor was performed. Histopathology examination confirmed the preoperative suspicion of esophageal GIST. Prognosis is reserved, the risk of relapse is very high given the fact that the tumor was extracted fragmented. Currently the patient is under treatment with imatinib mesylate and entered into clinical and imaging follow-up program, according toclinical guidelines.
