Case Report
Copyright ©2007 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 28, 2007; 13(16): 2385-2387
Published online Apr 28, 2007. doi: 10.3748/wjg.v13.i16.2385
Gastrointestinal stromal tumor of the stomach with a giant abscess penetrating the gastric lumen
Taro Osada, Akihito Nagahara, Tomohiro Kodani, Akihiro Namihisa, Masato Kawabe, Takashi Yoshizawa, Toshifumi Ohkusa, Sumio Watanabe
Taro Osada, Akihito Nagahara, Tomohiro Kodani, Akihiro Namihisa, Masato Kawabe, Takashi Yoshizawa, Toshifumi Ohkusa, Sumio Watanabe, Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Sumio Watanabe, Professor, Department of Gastroenterology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8421, Japan. sumio@med.juntendo.ac.jp
Telephone: +81-3-58021060 Fax: +81-3-38138862
Received: March 9, 2007
Revised: March 10, 2006
Accepted: March 15, 2007
Published online: April 28, 2007
Abstract

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. In large GISTs, cystic degeneration, necrosis and focal hemorrhage that occur inside the tumor can result in gastrointestinal bleeding. We describe a case of a 74-year old male with GIST of the stomach accompanied with a giant abscess that penetrated the gastric lumen. The patient experienced undiagnosed fever for two months prior to hospitalization. Gastrointestinal endoscopy, X-ray series and computed tomography of the patient’s abdomen revealed a gastric submucosal tumor in the fornix, with a fistula to the gastric lumen that was inundated with a great deal of pus. The mass was diagnosed as a GIST from biopsy specimens. The patient was treated by endoscopic drainage of the abscess and intravenous administration of antibiotics. Eventually, a partial gastrectomy was performed. He was also administered Imanitib mesylate as adjuvant therapy. He was followed up for 2 years and no metastasis or recurrence was recognized at the follow-up examinations. This is the first report of a patient with clearly diagnosed GIST with endoscopic evidence of an abscess penetrating into the gastric lumen.

Keywords: Gastrointestinal stromal tumor; Abscess; Drainage