A case of gastrointestinal stromal tumor of the stomach presented ball valve syndrome

Abstract

A case of gastrointestinal stromal tumor of the stomach presented ball valve syndrome in herein described. An 80-year-old woman with vomiting, abdominal fullness and melena was admitted to our hospital. Abdominal computed tomography scans visualized a tumor 5 centimeters in diameter in the duodenal bulb. Gastrointestinal endoscopy revealed that the elevated lesion was incarcerated into the duodenal bulb, and endoscopic reduction of the impaction was unsuccessful. The whole body of the tumor was unrevealed. Endoscopic ultrasonography showed the tumor originated from the fourth layer of the stomach. At surgery, we incised the anterior wall of the pyloric antrum and comfirmed that the tumor was a submucosal tumor. We reduced the tumor into the the stomach by hands, and performed a distal gastrectomy. Pathologically, the tumor, which measured 5 centimeters in diameter, was a gastrointestinal stromal tumor originated from the proper muscular layer and was positive for c-kit and negative for smooth muscle actin and S-100 protein on immunostainings. Gastrointestinal stromal tumor of the stomach was diagnosed with certainty.