Published online Aug 16, 2025. doi: 10.12998/wjcc.v13.i23.106140
Revised: March 30, 2025
Accepted: April 22, 2025
Published online: August 16, 2025
Processing time: 107 Days and 14.5 Hours
Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors that rarely present with gastrointestinal (GI) bleeding due to tumor erosion. GISTs com
A 42-year-old male presented with dark stools and light-headedness over five days. On examination, he was hypotensive, tachycardic, tachypneic, and had pallor. Laboratory tests revealed normocytic normochromic anemia, with a significant one-day drop in hemoglobin (from 7.2 g/dL to 6.4 g/dL). Upper GI endoscopy and colonoscopy were normal, but double-balloon enteroscopy revealed a subepithelial lesion distal to the duodenojejunal flexure, and an overlying ulcer. These findings were suggestive of GIST and were corroborated by a contract-enhanced computed tomography abdomen scan, which revealed a well-defined, homogenously-enhancing solid exophytic lesion (30 mm × 22 mm × 26 mm) arising from the proximal jejunal loops. He underwent resection anastomosis with complete en-bloc surgical removal of the lesion. Histopathological analysis of the resected specimen confirmed a GIST with presence of spindle cells and positive CD117 staining. His hemoglobin levels were stable on regular follow-ups, and there was no documented recurrence six months later.
GISTs should be suspected in cases of unexplained GI bleeding. Early diagnosis and complete surgical resection are key to favorable outcomes.
Core Tip: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors that rarely cause gastrointestinal (GI) bleeding. Mucosal ulceration and unfavorable tumor locations are risk factors for tumor progression and malignancy. We present a case of GI bleeding in a 42-year-old man complaining of melena over five days, which was diagnosed as a benign, ulcerated, jejunal GIST on histopathology and immunohistochemistry. Prompt evaluation using specialized diagnostic tools to locate obscure bleeding sources and complete surgical resection are key to favorable outcomes. GI bleeding in GIST is associated with a poor prognosis. Hence, detailed follow-ups are essential to detect and prevent tumor recurrence.