Limited Wedge Resection of a Duodenal Gist in a Patient with Intermittent Melena

• Published in: Liaquat National Journal of Cancer Care
• Main Authors: Fizzah Arif, Muhammad Arsalan Khan, Shah Muhammad, Syed Haider Mehdi
• Format: Article
• Language: English
• Published: Liaquat National Hospital and Medical College 2021-06-01
• Subjects: wedge resection; duodenal gastrointestinal stromal tumors; melena.
• Online Access: https://journals.lnh.edu.pk/lnjcc/pdf/96e296e3-6463-4bdb-8eab-7092f7e84998.pdf

Gastrointestinal Stromal Tumors account for 1% - 2% of all gastrointestinal (GI) tract tumors. Among GISTs, duodenal localization occurs in less than 5% and usually presents with upper GI bleeding. A 45-year-old man presented in the outpatient department with complaints of epigastric discomfort, intermittent melena and undocumented weight loss for the preceding 3 months. Initial upper GI endoscopy showed mild duodenitis and no other upper GI pathology. For unexplained symptoms, a CT Scan was performed which demonstrated a well-defined solid lesion along the second part of the duodenum. An endoscopic ultrasound (EUS)-guided biopsy of a subepithelial lesion at D2 was performed. Immunohistochemistry findings were suggestive of GIST. Wedge resection of the duodenal mass was done. Duodenal GIST should be considered as a differential in cases of GI bleeding when other differentials have been ruled out. Limited resection of duodenal GIST should be considered over pancreaticoduodenectomy, in case of small size tumors.