Abstract
A 70-year-old woman was referred to our hospital because of epigastric pain and dizziness. Abdominal CT scan revealed a well demarcated round tumor 7cm in diameter in the duodenum. Upper gastrointestinal endoscopy revealed that a cord like mucosa involving several streaks in the gastric fornix was impacted in the duodenal bulb, and the tip which was present in the duodenum was a submucosal tumor with ulceration. The tumor was clarified to be a submucosal tumor arising from the anterior wall of the gastric fornix after successful endoscopic reduction of the impaction. A biopsy revealed a suspicion of gastrointestinal stromal tumor (GIST). From these findings, we diagnosed the tumor as GIST with ulceration in the gastric fornix, growing toward the inside of the stomach. Then we performed laparoscopic intragastric surgery. The resected specimen was 70×50×52 mm in size. The pathology showed intermediate-grade GIST. The patient's postoperative course was uneventful. We report a case of a GIST in the gastric fornix with ball valve syndrome resected by laparoscopic intragastric surgery after successful endoscopic reduction of the impaction.
