ABSTRACT
Malignant gastrointestinal stromal tumor (GIST) consists a rare neoplasm, developing in small intestine and stomach. The presenting manifastations include weakness, weight loss, nausea, melena and anaemia. The present case refers to a 65 years old female patient with a GIST of the ampulla of Vater presenting with obstructive jaundice. Diagnosis was achieved pre-operatively by biopsies collected through diagnostic ERCP. The tumour was locally excised, with preservation of the ampulla. The histological analysis suggested low grade GIST positive for both CD 117 (c-kit) and CD34. Two years after the surgery the patient remains free of disease. Malignant GIST of the ampulla of the Vater is extremely rare as only few similar cases have been described in the literature. This is the first time a GIST being presented as obstructive jaundice ever reported. Despite the unavailability of EUS-FNA, the diagnosis was set preoperatively and the tumor was resected.
Subject(s)
Aged , Ampulla of Vater , Antigens, CD34/analysis , Cholangiopancreatography, Endoscopic Retrograde , Disease-Free Survival , Female , Gastrointestinal Stromal Tumors/complications , Humans , Jaundice, Obstructive/etiology , Proto-Oncogene Proteins c-kit/analysis , Biomarkers, Tumor/analysisABSTRACT
JUSTIFICATIVA E OBJETIVOS: Intoxicação hídrica e distúrbios eletrolíticos produzindo toxicidade sistêmica podem ocorrer durante ressecção prostática transuretral e cirurgia histeroscópica, sendo em geral causados pelo volume de líquido e pela duração do procedimento. RELATO DO CASO: Apresenta-se um caso incomum de intoxicação hídrica em uma paciente de 42 anos submetida à ressecção endoscópica de mioma uterino submucoso, com descrição do diagnóstico e do tratamento. CONCLUSÕES: A intoxicação hídrica pode ser resultado de sobrecarga líquida, sendo importante o controle cuidadoso dos líquidos empregados e monitorização clínica.