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Case Report

Malignant gastrointestinal stromal tumor (GIST) of the jejunum: the mysterious complex presentation

Parvez Mujawar, Dhiraj B Nikumbh, Kishor H Suryawanshi, Poonam S Pagare, Rajesh Thakur.


Gastrointestinal stromal tumors (GISTs) are malignant and rare form of soft tissue sarcoma of the digestive tract. The incidence of GIST is very low (2 in 1,00,000) while jejunal GIST are extremely rare, accounting for 0.1%–3% of all gastrointestinal (GI) tumors. GIST is usually associated with abdominal pain, palpable mass, or GI tract (GIT) bleeding. About 5% of GI hemorrhages are ambiguous in nature, with GISTs being one of the cause. We herein present a case of 78-year-old man of malignant GIST of jejunum. The patient had mysterious and complex presentation of repeated per rectal (P/R) bleeding and melena, which resulted in hypotension. Upper GI endoscopy and colonoscopy showed normal findings. Despite the symptomatic treatment and investigation, the cause was obscure. Hence, emergency laparotomy was performed and diagnosis rendered. The highlight of this case was unusual nature of malignant GIST presented with obscure overt GI bleeding and diagnosed only at life-saving laparotomy with further confirmation on histopathology.

Key words: Gastrointestinal stromal tumors, jejunum, gastrointestinal neoplasms

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