A case report: Peritonitis secondary to perforated locally advanced gastrointestinal stromal tumor.

INTRODUCTION AND IMPORTANCE: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms predominantly affecting the gastrointestinal tract. While they often remain asymptomatic, GISTs can lead to acute abdominal emergencies, such as peritonitis secondary to tumor perforation, a rare yet serious complication. Here, we present a unique case of a locally advanced ileal gastrointestinal stromal tumor complicated by generalized purulent peritonitis, emphasizing the diagnostic and management challenges associated with this condition. CASE PRESENTATION: A 68-year-old male presented with worsening abdominal pain, vomiting, fever, and weight loss. Imaging studies revealed a large solid-cystic mass originating from the terminal ileum, prompting emergency surgery. Intraoperative findings included a multilobulated tumor mass invading the mesocolon, necessitating hemicolectomy. Histopathological analysis confirmed a high-risk gastrointestinal stromal tumor, leading to initiation of adjuvant therapy with imatinib mesylate. CLINICAL DISCUSSION: GISTs often present with nonspecific symptoms, posing diagnostic challenges. Peritonitis secondary to tumor perforation is a rare yet critical complication requiring prompt surgical intervention. Complete resection remains the mainstay of treatment, with adjuvant imatinib therapy showing promise in high-risk cases. CONCLUSION: This case report sheds light on the complexities of diagnosing and managing locally advanced gastrointestinal stromal tumors (GISTs) complicated by peritonitis. Complete tumor resection is crucial for potential cure, with adjuvant therapy using imatinib showing promise, especially in high-risk cases. Thorough diagnostic assessment, timely intervention, and comprehensive follow-up are essential for optimizing outcomes in complex GIST presentations.

A rare case report: Huge ileal leiomyoma: Clinical presentation, management, and implications.

INTRODUCTION AND IMPORTANCE: Leiomyomas, commonly known as fibroids, are benign soft tissue tumors mostly found in the uterus. Although predominantly uterine, they can occur rarely in other areas, notably in the gastrointestinal tract. This article emphasizes an unusual case: an ileal leiomyoma in a 54-year-old patient, showcasing the distinct diagnostic and management challenges it presents. CASE REPORT: A 54-year-old female with no prior medical history presented with a progressively enlarging, painful abdominal mass over six months. Imaging suggested a Gastrointestinal Stromal Tumor (GIST), but guided biopsy yielded an unexpected diagnosis of ileal leiomyoma. Subsequent surgical intervention successfully removed the tumor, leading to an uneventful postoperative recovery. CLINICAL DISCUSSION: This case underscores the diagnostic intricacies and clinical manifestations of ileal leiomyomas. While diagnosis can be challenging, timely histopathological evaluation is crucial. Surgical resection guided by pathological findings played a pivotal role in this patient's care, emphasizing the need for a comprehensive approach to diagnosis and treatment in unique medical cases. CONCLUSION: The rarity of ileal leiomyomas presents a substantial challenge in the medical field, where expertise can be limited. This case emphasizes the pivotal role of histopathological analysis in confirming the diagnosis and guiding effective surgical management.