A wandering small bowel stromal tumor with a challenging imaging diagnosis

Federica Masino; Ruggiero Tupputi; Manuela Montatore; Giuseppe Maria Andrea D'Arma; Giuseppe Guglielmi

doi:10.23750/abm.v95i6.15656

A wandering small bowel stromal tumor with a challenging imaging diagnosis

Authors

Federica Masino Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Foggia, Italy https://orcid.org/0009-0004-4289-3289
Ruggiero Tupputi Radiology Unit, “Dimiccoli” Hospital, Barletta, Italy
Manuela Montatore Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Foggia, Italy
Giuseppe Maria Andrea D'Arma Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Foggia, Italy
Giuseppe Guglielmi Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Foggia, Italy; Radiology Unit, “Dimiccoli” Hospital, Barletta, Italy; Radiology Unit, “IRCCS Casa Sollievo della Sofferenza” Hospital, San Giovanni Rotondo (FG), Italy.

DOI: https://doi.org/10.23750/abm.v95i6.15656

Keywords:

abdominal mass, diagnostic imaging, GIST, small bowel stromal tumor, mobile tumor, wandering tumor

Abstract

We report a rare case of a small bowel stromal tumor, occurring in a 57-year-old female patient and presenting as an abdominal wandering mass on imaging.

The woman came to the emergency room complaining of recurrent diffuse abdominal pain, weight loss, and presenting anemia. She underwent an urgent CT scan of the abdomen that revealed the presence of a lower abdominal right mass of not easily recognizable origin. Subsequently, the patient was hospitalized, and an MRI was requested. The examination showed the same mass with a different location, having moved on the upper left side of the abdomen. An ultrasound was also performed to get a complete overview of imaging features. The mobile abdominal mass made imaging diagnosis challenging, which led to the hypothesis of a GIST, confirmed by histopathological biopsy.

References

Mantese G. Gastrointestinal stromal tumor: epidemiology, diagnosis, and treatment. Curr Opin Gastroenterol. 2019 Nov;35(6):555-559. doi: 10.1097/MOG.0000000000000584.

Lau S, Tam KF, Kam CK, et al. Imaging of gastrointestinal stromal tumour (GIST). Clin Radiol. 2004 Jun;59(6):487-98. doi: 10.1016/j.crad.2003.10.018.

Fujita T. Management of small gastrointestinal stromal tumours. Lancet. 2013 Nov 23;382(9906):1701. doi: 10.1016/S0140-6736(13)62397-1.

Ramani AS, Huske G, Noronha FP. A Rare Case of Mesenteric Gastrointestinal Stromal Tumor Presenting as Acute Abdomen. Niger J Surg. 2017 Jan-Jun;23(1):71-72. doi: 10.4103/1117-6806.199960.

Joensuu H, Hohenberger P, Corless CL. Gastrointestinal stromal tumour. Lancet. 2013 Sep 14;382(9896):973-83. doi: 10.1016/S0140-6736(13)60106-3.

Iorio N, Sawaya RA, Friedenberg FK. Review article: the biology, diagnosis and management of gastrointestinal stromal tumours. Aliment Pharmacol Ther. 2014 Jun;39(12):1376-86. doi: 10.1111/apt.12761.

Feng X, Yang Z, Zhang P, et al. Which size is the best cutoff for primary small gastric gastrointestinal stromal tumor? J Gastrointest Oncol. 2020 Apr;11(2):402-410. doi: 10.21037/jgo.2020.03.08.

Duarte AL, Fouassier S, Herédia V. MR imaging features of anal gastrointestinal stromal tumor (GIST). Diagn Interv Imaging. 2017;98(6):513-4. doi:10.1016/j.diii.2017.01.005.

Khouchoua S, Imrani K, Bourekba I, Guelzim Y, Moatassim Billah N, Nassar I. Chronic abdominal pain revealing a gastrointestinal stromal tumor. Radiol Case Rep. 2023 Dec 20;19(3):961-965. doi: 10.1016/j.radcr.2023.11.053.