Malignant duodenal stromal tumor: the first case report in Thailand and review of the literature.

ABSTRACT

The authors presented a middle aged Thai patient with malignant duodenal stromal tumor identified at a tertially care centre in Thailand. The patient presented with obscure gastrointestinal bleeding and the small bowel endoscopy revealed a bleeding tumor mass at the fouth part of the duodenum. The patient underwent segmental duodenectomy with end to end anstosomis. The histopathology of the tumor composed of interlacing bundles of spindle cells with oval to elongated pleomorphic nuclei and eosinophilic cytoplasm. The immunohistochemistrical study confirmed the diagnosis of malignant stromal tumor with smooth muscle differentiation. The computer tomography scan (CT scan) of the abdomen showed no evidence of metastasis. Postoperatively, the patient's clinical condition showed continuous improvement without further gastrointestinal bleeding. The patient has remained healthy up to present (six months of follow-up). A high level of suspicion to detect this malignant tumor especially in a patient presenting with obscure gastrointestinal bleeding and effective surgical treatment allow better clinical outcome in this rare and fatal malignancy.