Unusual location of gastrointestinal stromal tumor (GIST): A case report and literature review of greater omentum location.

INTRODUCTION: Gastrointestinal stromal tumors (GISTs) represent a unique subset of neoplasms within the digestive tract. They can manifest in various organs throughout the digestive tract, ranging from the oral cavity to the anus, with a predilection for the stomach and small intestine. A distinct subtype of GISTs, known as Extra-gastrointestinal stromal tumors (EGISTs), originate outside the typical GIST organs such as the mesentery, retroperitoneum, and occasionally the omentum. EGISTs are relatively rare, accounting for <5 % of all GIST cases. PRESENTATION OF CASE: We present the case of a 30-year-old female patient who presented with an upper abdominal mass associated with anorexia, fever, and weakness. Radiographic imaging revealed a cystic mass beneath the left hypochondrium. Exploratory laparoscopy confirmed the presence of an isolated mass adherent to the gastrocolic ligament and greater omentum. Histopathological examination confirmed GIST, characterized by spindle-shaped cells with DOG1 and CD117/C-kit expression. The patient underwent successful tumor resection and was discharged home with postoperative imatinib therapy. Follow-up at 14 months showed no recurrence. DISCUSSION: The rarity of Gastrointestinal Stromal Tumors (GISTs) in the Greater Omentum highlights diagnostic challenges and underscores the need for further research. Immunohistochemical analysis aids in diagnosis, with Ki-67 staining indicating a high-risk classification. Surgery remains the primary treatment, with potential adjuvant therapy utilizing Imatinib mesylate. CONCLUSION: Our case underscores the rare occurrence of GIST in the Greater Omentum. Despite their infrequency, EGISTs should be considered in intra-abdominal masses, emphasizing accurate diagnosis for appropriate management and the need for further research.

Acute abdomen with gastric volvulus revealing an underlying pneumatosis cystoides intestinalis: a case report.

BACKGROUND: Pneumatosis intestinalis is an abnormal presence of free air outside the lumen of the intestines in many shapes. It is classified based on its etiology to primary or secondary, it affects adults as well as infants and can involve any part of the GI tract. CASE PRESENTATION: We report a case of a 55-year-old man with a past medical history of a surgically repaired perforated duodenal ulcer who presented with an acute abdominal pain, Flatulence and constipation. On examination of the abdomen; severe distension, tenderness and tympanicity on percussion were noted. An erect CXR was performed and showed bilateral sub-diaphragmatic air levels. We performed an abdominal Paracentesis under the right subcostal margin which led to evacuation of large amounts of air. Next, an investigational laparotomy showed that the reason was a gastric volvulus associated with an anterior and posterior gastric wall lacerations. The suitable surgical repair approach was taken, but another lesion was detected incidentally. A pneumatosis cystoides intestinalis (PCI) was extended along large length of the intestines in many shapes and without any symptoms or signs. CONCLUSIONS: Pneumatosis cystoides intestinalis has been reported continuously in relation to peptic ulcer disease (PUD). We aim to report a new association of a gastric volvulus and PCI secondary to pyloric stenosis caused by a duodenal ulcer; which we believe can aid in the diagnosing of dangerous complications, of a rare disease.

An inguinal hernia revealing an advanced stage gastric cancer in a young patient: A case report.

Introduction: Gastric cancer (GC) is the fifth most common cancer and the fourth leading cause of death. It is much more common in advanced age and it is rare among the youngest patients (under 45 years of age). Case presentation: we report an unusual presentation of advanced gastric adenocarcinoma in 39-year-old man, who presented to our hospital with inguinal hernia without obvious gastrointestinal symptoms. He had strong family history of cancer, heavy smoking habit and weight loss. The intra-operative procedure identified a cyanotic separate spermatocele which was confirmed by the urologist. During investigation we found multiple liver metastasis in abdominal CT and advanced gastric adenocarcinoma from gastric biopsy and metastasis in spermatic cord sample and peritoneum sample of poorly differentiated adenocarcinoma. Conclusion: Although stomach adenocarcinoma is extremely rare in young patient but it should be kept in mind of physicians as a possible diagnosis if there are many risk factors.