Abstract
Multiple sporadic gastrointestinal stromal tumors (GISTs) are rare excepting those restricted to von Recklinghausen disease or hereditary conditions. We report a case of a duodenal GIST resected 9 years after resection of a gastric GIST without hereditary nature. The patient was a 75-year-old woman who had been followed up annually with CT examination after pylorus preserving gastrectomy for a gastric GIST at the age of 66. A 20-mm solid tumor was detected in the horizontal part of the duodenum by CT examination 9 years after the stomach surgery. The tumor was diagnosed as a duodenal GIST by a boring biopsy, and we performed wedge resection of the duodenum. The cell type of these GISTs was spindle, and both tumors were positive for c-kit. However, these GISTs showed different stainabilities for CD34 and αSMA, and c-kit gene mutations were different between these GISTs. Therefore, we diagnosed these GISTs to be sporadic multiple GISTs. Because the duodenal GIST entails a very low risk, the patient has been followed up periodically without adjuvant therapy. We should follow the clinical course of GIST by keeping a possibility of the multiple sporadic occurrence in mind.
