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  • Title: [A case of emergency resection of a giant gastrointestinal stromal tumor of the stomach associated with hemorrhagic shock].
    Author: Aomatsu N, Nakamura M, Takeuchi K, Nishii T, Kosaka K, Uchima Y, Nakajima H, Hanno H, Takeda O, Kawamura M, Takayanagi S, Hirooka T, Dozaiku T, Hirooka T, Aomatsu K.
    Journal: Gan To Kagaku Ryoho; 2013 Nov; 40(12):2185-7. PubMed ID: 24394054.
    Abstract:
    We report a case of emergency resection of a giant gastrointestinal stromal tumor of the stomach associated with hemorrhagic shock. A 79-year-old woman was admitted to our hospital because of massive hematemesis. Laboratory analysis revealed a hemoglobin level of 6.5 g/dL. Abdominal computed tomography (CT) and upper gastrointestinal endoscopy revealed a submucosal tumor, 12 cm in diameter, in the fornix of the stomach. As a Dieulafoy-like lesion was present, we attempted coagulation hemostasis in the exposed blood vessels. Endoscopic hemostasis was not successful. The patient went into hemorrhagic shock. Emergency surgery was performed: total gastrectomy with distal pancreatosplenectomy. The resected specimen measured 10×12×7 cm and was hard. Immunohistologically, the tumor was positive for c-kit and CD34 and negative for alpha smooth muscle actin (αSMA), desmin, and S-100. Histological examination revealed that the patient had a high-risk gastrointestinal stromal tumor of the stomach with no nodal metastasis. The postoperative course was uneventful and the patient has remained alive without recurrence for 4 years.
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