TOTAL GASTRECTOMY IN A PATIENT WITH ABSCEDED GASTROINTESTINAL STRUM TUMOR

• DOI: 10.22533/at.ed.1592512201092

• Palavras-chave: GIST; tumor; lesion.

• Keywords: GIST; tumor; lesion.

• Abstract:

  Gastrointestinal stromal tumor (GIST) is a mesenchymal tumor, predominantly affecting the stomach, in the gastrointestinal tract (GIT). It is rare, accounting for about 0.1-3% of GI tumors. These neoplasms can be asymptomatic, but in the case reported, they produced epigastric pain, weight loss and vomiting. Upper digestive endoscopy showed a vegetating lesion in a small proximal curvature, with purulent drainage. The lesion was biopsied, revealing a nonspecific chronic inflammatory process. Abdominal CT identified a contiguous tumor of the stomach, with formation of an air-fluid level, partially rejecting the left hepatic lobe. Diagnostic laparoscopy was indicated, converted to conventional laparotomy: bulky, solid-cystic lesion, measuring 15 cm, occupying the proximal 2/3 of the lesser gastric curvature. The lesion was biopsied, revealing a nonspecific chronic inflammatory process. Abdominal CT identified a tumor contiguous to the stomach, with formation of an air-fluid level, partially rejecting the left hepatic lobe. In the aforementioned report, the most striking was the presence of fetid eructations produced by tumor necrosis; possibly, with the growth of the lesion, with invasion of the stomach lumen, determining an intratumoral abscess, and generating the clinical picture described. vegetating lesion in small proximal curvature, with purulent drainage. Despite this, because the lesion was well circumscribed, without rupture, there was no tumor dissemination, not even a picture of abdominal sepsis. Total gastrectomy and Roux-en-Y esophagojejunostomy were performed, with histopathology of the mesenchymal neoplasm piece compatible with GIST, showing 4 mitoses/50 fields (40x). The patient had a satisfactory evolution, being discharged from the hospital on the tenth postoperative day.

• Número de páginas: 6