1/50. Renal angiomyolipoma resembling gastrointestinal stromal tumor with skenoid fibers.We report an unusual case of renal angiomyolipoma occurring in 68-year-old man. The tumor lacked well-developed vascular and adipose components and was composed almost exclusively of smooth muscle cells. Numerous skenoid-like periodic acid-Schiff-positive globules were interspersed between the tumor cells; the lesion therefore closely resembled a low-grade stromal tumor of the gastrointestinal tract. The HMB45-positive/CD34-negative immunophenotype was essential for the diagnosis of angiomyolipoma. Neither gastrointestinal tumor nor any signs of tuberous sclerosis were found. This lesion should be included in the list of morphologic variations of angiomyolipoma, which may cause diagnostic difficulties.- - - - - - - - - - ranking = 1keywords = gastrointestinal stromal, stromal (Clic here for more details about this article) |
2/50. Pedunculated exogastric leiomyosarcoma: case report and brief literature review.A case report and review of the literature on pedunculated exogastric leiomyosarcomas are presented. Although about one-fourth of the stromal tumors (common leiomyomas and leiomyosarcomas) of the stomach grow in an exogastric configuration, pedunculated exogastric leiomyosarcomas are extremely rare. At present there is no evidence of intraperitoneal seeding from exogastric leiomyosarcomas. Consequently, a local resection with an adequate margin is sufficient when no invasion to the adjacent structures, is observed.- - - - - - - - - - ranking = 0.0045256079196988keywords = stromal (Clic here for more details about this article) |
3/50. 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 = 0.013576823759096keywords = stromal (Clic here for more details about this article) |
4/50. A case of gastrointestinal stromal tumor of the stomach.In a 55-year-old man, a tumor about 3 cm in diameter was detected in the upper abdomen by abdominal ultrasound screening during follow-up of chronic hepatitis c discovered in 1990. There were no symptoms and no abnormalities on physical examination. Tests for tumor markers were negative. By barium meal and gastroscopy, submucosal tumor was found on the lesser curvature of the stomach, with bridging fold in the absence of central ulceration. biopsy revealed no tumor tissue. Under the diagnosis of submucosal tumor of the stomach, either a leiomyoma or leiomyosarcoma, partial resection of stomach was performed. Direct invasion of the surrounding organs, lymph node metastasis or distant metastasis was not observed grossly in the operation. Histologic examination of the resected specimen revealed proliferation of spindle cells and oval cells in an interlacing pattern. immunohistochemistry for CD34, vimentin and c-kit protein was strongly positive, while smooth muscle actin, S-100 protein, desmin and p53 protein were negative. The proliferating cell nuclear antigen index was about 50%, while the MIB-1 index was < or = 1%. From these findings, this tumor was diagnosed as a gastrointestinal stromal tumor of the uncommitted type.- - - - - - - - - - ranking = 1.2443429901004keywords = gastrointestinal stromal, stromal (Clic here for more details about this article) |
5/50. Uterine endometrial stromal sarcoma located in uterine myometrium: MRI appearance.Two cases of uterine endometrial stromal sarcoma whose main mass was located in uterine myometrium are reported. They mimicked uterine leiomyoma with cystic degeneration or uterine leiomyosarcoma. Endometrial stromal sarcoma should be suggested in the differential diagnosis of mass lesion in uterine myometrium.- - - - - - - - - - ranking = 0.027153647518193keywords = stromal (Clic here for more details about this article) |
6/50. Surgical management of gastrointestinal stromal tumors of the stomach.BACKGROUND: gastrointestinal stromal tumors (GISTs) are rare tumors of the GI tract with varying degree of dignity and prognosis. Intramural or extragastral growth of gastric GISTs is associated with diagnostic difficulties and uncertainty about the type and extent of surgical therapy. Based on our experience, we tried to formulate management guidelines for gastric GISTs. methods: Five patients with gastric GIST (36-85 years old) underwent subserosal excision with subsequent B-II resection (1x), full-thickness partial gastric resection (2x), gastrotomy with submucosal excision (1x), or gastrectomy for carcinoma with an incidental finding of a leiomyoma (1x). RESULTS: Tumor size ranged from 2x2x1 cm to 9x6x4 cm. These tumors were classified as epithelioid leiomyosarcoma (1x), GIST (3x), or leiomyoma (1x). The prognosis of risk ranged from no risk (leiomyoma) to low-malignancy (leiomyosarcoma) depending on tumor size and mitotic index. No recurrent disease has been noted so far during follow-up ranging from 3 months to 6 years. CONCLUSIONS: Staging of gastric disease should include the probability of gastric GIST. Surgical resection is the therapy of choice for potential malignant GISTs to ensure a local radical removal. Metachronic metastases should be resected if possible. Depending on tumor stage and prognostic parameters, an individual follow-up with endoscopic and radiologic examinations is recommended. Further studies should be undertaken to elaborate prognostic determinants and stage-adapted treatment.- - - - - - - - - - ranking = 1keywords = gastrointestinal stromal, stromal (Clic here for more details about this article) |
7/50. Malignant stromal tumour of the rectum: findings at endorectal ultrasound and MRI.This case report describes the findings on endorectal ultrasound and MRI in a patient with a giant malignant stromal tumour of the rectum. A review of imaging characteristics and histopathological findings as described in the literature is presented.- - - - - - - - - - ranking = 0.37443850007857keywords = stromal tumour, stromal (Clic here for more details about this article) |
8/50. Autoimmune hemolytic anemia associated with postirradiation malignant stromal tumor (leiomyosarcoma) of the jejunum.We describe a patient who presented with autoimmune hemolytic anemia and small bowel obstruction secondary to a malignant stromal tumor (leiomyosarcoma) of the jejunum, 25 years postchemotherapy and radiation treatment for stage IIA Hodgkin's disease. The patient was treated with corticosteroid therapy and surgical resection of the jejunal tumor. We conclude that autoimmune hemolytic anemia may be an unusual presentation for postirradiation sarcoma.- - - - - - - - - - ranking = 0.022628039598494keywords = stromal (Clic here for more details about this article) |
9/50. leiomyosarcoma of third part of duodenum with perforation.Malignant stromal cell tumors of the duodenum present with pain or bleed. We report a patient with leiomyosarcoma of the third part of the duodenum that presented with perforation.- - - - - - - - - - ranking = 0.0045256079196988keywords = stromal (Clic here for more details about this article) |
10/50. Can fine needle aspiration cytology adequately diagnose and predict the behavior of gastrointestinal stromal tumors?The use of endoscopic ultrasound-guided fine needle aspiration is expanding rapidly in many centers. This method can be used to produce aspirate specimens from masses in the pancreas, liver, retroperitoneum, adrenals, and mediastinum, as well as mural nodules in the upper gastrointestinal tract. As application of this method continues to grow, it is reasonable to expect that the demand for cytologic diagnosis of gastrointestinal stromal tumors will increase. In this commentary, the cytologic presentation of one such case is offered. This is used to illustrate the clinical, immunohistochemical, and molecular biologic features that are used to suggest the prognosis of a given lesion.- - - - - - - - - - ranking = 1.2443429901004keywords = gastrointestinal stromal, stromal (Clic here for more details about this article) |
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