Abstract
We report a case of gastrointestinal stromal tumor (GIST) of the small intestine presented with shock due to massive hemoperitoneum. A 70-year-old man was in a shock state when he arrived at our hospital. He went to another clinic because of sudden abdominal pain and syncope, and was moved to this hospital. Abdominal CT showed a 10-cm-sized tumor with extravasation in the lower abdomen and fluid in the abdominal cavity. We diagnosed the massive hemoperitoneum due to the rupture of an intrapelvic tumor, and performed an emergency operation. Laparotomy revealed a hemispherical mass of the small intestine (10 cm in diameter), and an outgrowing mass in the ileum at about 120 cm distant form the Treitz's ligament. We performed a partial resection of the small intestine. The size was 10×9×5 cm. H-E staining showed proliferation with spindle shaped cells. Immunohistochemical stainings showed positive responses to c-kit and CD34. Mitotic Index was 39/50HPF. So we made the definite diagnosis of GIST of small intestine, high risk group. Now the patient is in good condition without metastasis or recurrence.
