1/6. Gastric leiomyosarcoma presenting as a sentinel hemorrhage.A 43-year-old Asian woman who was initially seen because of hematemesis later had a gastric leiomyosarcoma diagnosed. Epigastric palpation, computed tomography, and magnetic resonance imaging assisted in determining the size, borders, and location of the tumor while a second esophagogastroduodenoscopy revealed friable gastric mucosa with erosions. biopsy specimens taken for frozen section during surgical abdominal exploration revealed a malignant gastric stromal tumor. An en bloc excision of the mass then followed, with the final pathologic diagnosis a gastric leiomyosarcoma. Metastases were later found in the liver, peritoneum, and mesentery. Differentiation of gastric leiomyosarcoma from other stromal tumors is difficult and requires standardized nuclear and cellular evaluation of atypia, necrosis, mitosis, and tumor doubling time. The most common symptoms at initial presentation are abdominal pain and gastrointestinal bleeding. Abdominal computed tomography remains more specific in suggesting gastric stromal tumors than esophagogastroduodenoscopy and upper gastrointestinal barium series. lymph node involvement in gastric leiomyosarcoma is rare and affords the first-line therapy of laparoscopic wedge gastrectomy with a good prognosis in tumors less than 6 cm in diameter. The prognostic factors include metastasis, size of the tumor, histologic grade, dna ploidy of the tumor, and ulceration of overlying gastric mucosa.- - - - - - - - - - ranking = 1keywords = stromal (Clic here for more details about this article) |
2/6. Bronchial granular cell tumor with osteopontin and osteonectin expression: a case report.The case of a 52-year-old Japanese man with bronchial granular cell tumors with osteopontin and osteonectin expression is reported here because there have been few investigations of their expression in benign tumors. He was admitted because of sudden hematemesis. A bronchoscopic examination revealed a lobulated polypoid tumor located in the left and right bronchi. Histologically, most tumor cells had abundant granular eosinophilic cytoplasm and were immunoreactive for S-100, neuron-specific enolase (NSE), CD68 and vimentin. Moreover, osteopontin-positive tumor cells were randomly distributed in the tumor tissue, but few stromal cells were positive. In contrast, osteonectin was mainly expressed in the peripheral tumor cells and was also distributed in the stromal cells. blood vessels at the tumor border in which osteonectin-positive tumor cells were distributed, proliferated moderately. These results suggest that osteopontin and osteonectin may play a role in the progression of granular cell tumors and in the interaction between the tumor and host or angiogenesis around the tumor, respectively.- - - - - - - - - - ranking = 0.66666666666667keywords = stromal (Clic here for more details about this article) |
3/6. Malignant duodenal stromal tumor: the first case report in thailand and review of the literature.The authors presented a middle aged Thai patient with malignant duodenal stromal tumor identified at a tertially care centre in thailand. The patient presented with obscure gastrointestinal bleeding and the small bowel endoscopy revealed a bleeding tumor mass at the fouth part of the duodenum. The patient underwent segmental duodenectomy with end to end anstosomis. The histopathology of the tumor composed of interlacing bundles of spindle cells with oval to elongated pleomorphic nuclei and eosinophilic cytoplasm. The immunohistochemistrical study confirmed the diagnosis of malignant stromal tumor with smooth muscle differentiation. The computer tomography scan (CT scan) of the abdomen showed no evidence of metastasis. Postoperatively, the patient's clinical condition showed continuous improvement without further gastrointestinal bleeding. The patient has remained healthy up to present (six months of follow-up). A high level of suspicion to detect this malignant tumor especially in a patient presenting with obscure gastrointestinal bleeding and effective surgical treatment allow better clinical outcome in this rare and fatal malignancy.- - - - - - - - - - ranking = 2keywords = stromal (Clic here for more details about this article) |
4/6. Gastrointestinal stromal tumours of the oesophagus.A rare case of gastrointestinal stromal tumour (GIST) of the oesophagus is presented. Pathological features with a review of the treatment options and the literature are presented.- - - - - - - - - - ranking = 106.81308816222keywords = gastrointestinal stromal tumour, gastrointestinal stromal, stromal tumour, stromal (Clic here for more details about this article) |
5/6. Multiple gastrointestinal stromal tumors and synchronous ileal carcinoids.BACKGROUND: A 74-year-old African-American male presented with a 3-day history of hematemesis and melena. The patient reported no abdominal pain, constitutional symptoms, bright red blood per rectum, constipation, or diarrhea. His physical examination and medical history were unremarkable except for benign prostatic hypertrophy. An esophagogastroduodenoscopy showed a 3 x 2 x 2 cm smooth round mass in the cardia, 2 cm distal to the gastroesophageal junction. biopsy of the mass revealed an ulcerated tumor composed of spindle cells. immunohistochemistry showed positive staining for a number of biochemical markers, including KIT, Ki-67 and smooth muscle actin, but was negative for the markers S100 and desmin. A gastric-wedge resection revealed an ulcerated 4.5 cm mass in the stomach, and exploration of the abdomen revealed two ileal carcinoid tumors, jejunal diverticula and reactive mesenteric lymphadenopathy. INVESTIGATIONS: Esophagogastroduodenoscopy, biopsy, CT scan, immunohistochemistry, dna microarray analysis and quantitative reverse transcriptase-PCR. diagnosis: Multiple gastrointestinal stromal tumors occurring concomitantly with ileal carcinoids. MANAGEMENT: Gastric-wedge resection and segmental resection.- - - - - - - - - - ranking = 121.55318990376keywords = gastrointestinal stromal, stromal (Clic here for more details about this article) |
6/6. Gastric stromal tumor: treatment by snare polypectomy.A patient presenting with hematemesis was detected to have a 3 cm sized pedunculated polyp in the gastric antrum. A snare polypectomy was performed. Histopathology of polyp revealed it to be benign submucosal stromal tumor.- - - - - - - - - - ranking = 1.6666666666667keywords = stromal (Clic here for more details about this article) |