CRCM  Vol.3 No.11 , November 2014
Pregnancy with Gastric Stromal Tumor
ABSTRACT
Background: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract. GIST are rare during pregnancy. We report here the case of a patient who was admitted in our university hospital for GIST discovered during the second trimester of pregnancy. She was 42 years old, in the fifth months of pregnancy. She was admitted for biliary colic pain with vomiting. On abdominal examination, we objectified a distended abdomen with uterine height of 18 cm and epigastric mass of 10 cm. Abdominal ultrasound and magnetic resonance imaging (MRI) showed a hepatic, tissue and cystic mass, developing at the expense of the left liver. Endoscopy objectified an aspect of extrinsic compression at the front of the stomach. A cesarean was scheduled at the 35th month of pregnancy for fetal extraction and rescue. Exploration of the peritoneal cavity during surgery has objectified a hepatic highly vascularised mass reaching up to the umbilicus. This mass was unresectable. A postoperative CT scan revealed a large bilobed epigastric mass adhering to the stomach and the left liver. Histological and immunohistochemical study of hepatic process showed a gastrointestinal stromal tumor of high risk of malignancy. Conclusion: few cases have been reported in the literature on GIST during pregnancy showing the rarity of the condition that requires multidisciplinary care.
KEYWORDS
GIST, Pregnancy, Imatinib

Cite this paper
Charif, I. , Khalil, N. , Ousadden, A. , Benjelloun, E. , Slimani, O. , Alaoui, F. , Hijri, F. , Mesbahi, O. , Ibrahimi, A. and Mellouki, I. (2014) Pregnancy with Gastric Stromal Tumor. Case Reports in Clinical Medicine, 3, 571-576. doi: 10.4236/crcm.2014.311124.
References
[1]   Cuerva-Gonzalez, M.J., Lacoponi, S., de la Calle-Fernandez, M. and Pozo-Krielinger, J. (2010) Gastrointestinal Stromal Tumor in Pregnancy and Control. Case Report. Ginecologia y Obstetricia de Mexico, 78, 697-702.

[2]   Gold, J.S. and Dematteo, R.P. (2006) Combined Surgical and Molecular Therapy: The Gastrointestinal Stromal Tumor Model. Annals of Surgery, 244, 176-184.
http://dx.doi.org/10.1097/01.sla.0000218080.94145.cf

[3]   Abbas, M., Farouk, Y., Nasr, M.M., Elsebae, M.M., Farag, A., Akl, M.M., et al. (2008) Gastrointestinal Stromal Tumors (GISTs): Clinical Presentation, Diagnosis, Surgical Treatment and Its Outcome. Journal of the Egyptian Society of Parasitology, 38, 883-894.

[4]   Lanteri, R., Aliotta, I., Racalbuto, A. and Licata, A. (2005) Anal GIST in Older Old Patient: A Case Report. Il Giornale di chirurgia, 26, 135-137.

[5]   Du, C.Y., Shi, Y.Q., Zhou, Y., Fu, H. and Zhao, G. (2008) The Analysis of Status and Clinical Implication of KIT and PDGFRA Mutations in Gastrointestinal Stromal Tumor (GIST). Journal of Surgical Oncology, 98, 175-178.
http://dx.doi.org/10.1002/jso.21104

[6]   Emma, T., Igras, A., Susan, J. and Neuhaus, C. (2012) Maternal GIST in Twin Pregnancy: Case Report of a Rare and Complex Management Challenge. Gynecologic Oncology Reports, 2, 133-135.
http://dx.doi.org/10.1016/j.gynor.2012.08.001

[7]   Chaudhry, U.I. and DeMatteo, R.P. (2009) Management of Resectable Gastrointestinal Stromal Tumor. Hematology/ Oncology Clinics of North America, 23, 79-96.
http://dx.doi.org/10.1016/j.hoc.2009.01.001

[8]   Neagu, S., Zarnescu, N.O., Costea, R., Stamatoiu, A., Badea, V., Dumitrescu, C., et al. (2003) Gastric Stromal Tumors: Clinical and Histopathological Analysis of Four Cases. Chirurgia, 98, 443-451.

[9]   Folgado Alberto, S., Sanchez, P., Oliveira, M., Cuesta, L., Gomes, F., Figueiredo, A., et al. (2008) Gastrointestinal Stromal Tumors—A Retrospective Study of 43 Cases. Revista Espanola de Enfermedades Digestives, 100, 696-700.

[10]   Patil, S., Jain, S. and Kaza, R.C. (2011) Chamberlain RS: Giant Gastrointestinal Stromal Tumor Presenting as a Palpable Abdominal Mass: An Unusual Presentation. ISRN Surgery, Article ID: 894829.

[11]   Scarpa, M., Bertin, M., Ruffolo, C., Polese, L., D’Amico, D.F. and Angriman, I. (2008) A Systematic Review on the Clinical Diagnosis of Gastrointestinal Stromal Tumors. Journal of Surgical Oncology, 98, 384-392.
http://dx.doi.org/10.1002/jso.21120

[12]   Emile, J.F., Theou, N., Tabone, S., Cortez, A., Terrier, P., Chaumette, M.T., et al. (2004) Clinicopathologic, Phenotypic, and Genotypic Characteristics of Gastrointestinal Mesenchymal Tumors. Clinical Gastroenterology and Hepatology: The Official Clinical Practice Journal of the American Gastroenterological Association, 2, 597-605.

[13]   Heinrich, M.C. (2010) Imatinib Treatment of Metastatic GIST: Don’t Stop (Believing). The Lancet Oncology, 11, 910-911.
http://dx.doi.org/10.1016/S1470-2045(10)70225-4

[14]   Dei Tos, A.P. (2003) GIST: From Diagnosis to Molecular Therapy. Pathologica, 95, 251.

 
 
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