ID 110653
Author
Miyauchi, Takayuki Department of Surgery, National Kochi Hospital
Nisioka, Masanori Department of Surgery, National Kochi Hospital
Kashiwagi, Yutaka Department of Surgery, National Kochi Hospital
Miki, Hisatsugu Department of Surgery, National Kochi Hospital
Sato, Yasunori Department of gastroenterology, National Kochi Hospital
Endo, Noriko Department of gastroenterology, National Kochi Hospital
Uemura, Takashige Department of gastroenterology, National Kochi Hospital
Inoue, Shuji Department of gastroenterology, National Kochi Hospital
Hiroi, Makoto Department of pathology, National Kochi Hospital
Kikutsuji, Toru Department of Surgery, Kohoku Municipal Hospital
Ohgami, Naoko Department of Medicine Kohoku Municipal Hospital
Keywords
gastrointestinal stromal tumor
esophageal hiatus hernia
self-expandable metallic stent
Content Type
Journal Article
Description
An 85-year-old woman was admitted to our hospital because of vomiting. An upper gastrointestinal series what showed a large esophageal hiatus hernia, suggesting an association with extrinsic pressure in the middle portion of the stomach. An upper gastrointestinal endoscopic examination showed severe esophagitis and a prominent narrowing in the middle portion of the stomach, however, it showed normal gastric mucosa findings. CT and MRI revealed a large tumor extending from the region of the lower chest to the upper abdomen. From these findings, the tumor was diagnosed as gastrointestinal stromal tumor(GIST), which arose from the gastric wall and complicated with an esophageal hiatus hernia. We performed a laparotomy, however, the tumor showed severe invasion to the circumferential organs. Therefore, we abandoned the excision of the tumor. Histologically, the tumor was composed of spindle shaped cells with marked nuclear atypia and prominent mitosis. The tumor cells were strongly positive for CD34 and c-kit by immunohistochemical examination. From these findings, the tumor was definitely diagnosed as a malignant GIST. As palliative treatment, we implanted a self-expandable metallic stent in the narrow segment of the stomach. The patient could eat solid food and was discharged. In the treatment of esophageal hiatus hernia, the rare association of GIST should be considered.
Journal Title
The journal of medical investigation : JMI
ISSN
13431420
NCID
AA11166929
Volume
49
Issue
3-4
Start Page
186
End Page
192
Sort Key
186
Published Date
2002
FullText File
language
eng
TextVersion
Publisher
departments
Science and Technology