Case Report
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 16, 2025; 13(23): 106140
Published online Aug 16, 2025. doi: 10.12998/wjcc.v13.i23.106140
Ulcerated benign jejunal gastrointestinal stromal tumor causing gastrointestinal bleeding: A case report
Rick Maity, Roger B Rathna, Arkadeep Dhali, Nathaniel Fernandes, Jyotirmoy Biswas, Gurpreet S Kapoor, Gopal K Dhali
Rick Maity, General Medicine, Institute of Post Graduate Medical Education and Research, Kolkata 700020, India
Roger B Rathna, Internal Medicine, University Hospitals of Leicester NHS Trust, Leicester LE1 5WW, United Kingdom
Arkadeep Dhali, Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Sheffield S5 7AU, United Kingdom
Arkadeep Dhali, School of Medicine and Population Health, University of Sheffield, Sheffield S10 2HQ, United Kingdom
Arkadeep Dhali, Deanery of Clinical Sciences, University of Edinburgh, Edinburgh EH16 4SB, United Kingdom
Arkadeep Dhali, School of Medicine, University of Leeds, Leeds LS2 9JT, United Kingdom
Nathaniel Fernandes, Vascular Surgery, Royal Free London NHS Foundation Trust, London NW3 2QG, United Kingdom
Jyotirmoy Biswas, General Medicine, College of Medicine and Sagore Dutta Hospital, Kolkata 700058, India
Gurpreet S Kapoor, Gopal K Dhali, Department of Gastroenterology, Institute of Post Graduate Medical Education and Research, Kolkata 700020, India
Co-first authors: Rick Maity and Roger B Rathna.
Co-corresponding authors: Arkadeep Dhali and Gurpreet S Kapoor.
Author contributions: Maity R, Rathna RB, and Fernandes N conducted literature review and wrote the primary manuscript; Maity R and Rathna RB contributed equally to this article, they are the co-first authors of this manuscript; Dhali A conceptualized the article and wrote the primary manuscript; Biswas J and Kapoor GS wrote the primary manuscript; Dhali GK supervised the work and wrote the revised manuscript; Dhali A and Kapoor GS contributed equally to this article, they are the co-corresponding authors of this manuscript; and all authors have read and approved the final manuscript.
Informed consent statement: Informed consent was taken from the patient for anonymous publication of the case report.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Arkadeep Dhali, MBBS (Hons), MPH, PGCert Clin Ed, MAcadMEd, FRSPH, NIHR Academic Clinical Fellow, Academic Unit of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital, Herries Road, Sheffield S5 7AU, United Kingdom. arkadipdhali@gmail.com
Received: February 17, 2025
Revised: March 30, 2025
Accepted: April 22, 2025
Published online: August 16, 2025
Processing time: 107 Days and 14.5 Hours
Abstract
BACKGROUND

Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors that rarely present with gastrointestinal (GI) bleeding due to tumor erosion. GISTs commonly arise in the stomach, followed by the small bowel. They are typically diagnosed through histopathology and immunohistochemistry. The presence of mucosal ulceration and tumor locations outside the stomach are linked with a greater risk of tumor progression to malignancy. This case highlights a benign ulcerated jejunal GIST presenting as GI bleeding.

CASE SUMMARY

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.

CONCLUSION

GISTs should be suspected in cases of unexplained GI bleeding. Early diagnosis and complete surgical resection are key to favorable outcomes.

Keywords: Gastrointestinal stromal tumor; Gastrointestinal bleeding; Jejunal tumor; Small bowel; Double-balloon enteroscopy; Endoscopy; Case report

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.