Emergency Surgery for a Case of Torsion and Necrosis Involving a Small Gastric Gastrointestinal Stromal Tumor (GIST)

Abstract

A 64-year-old woman, who had been under regular follow-up for a gastric submucosal tumor (SMT) discovered during a routine health checkup, presented to the emergency department with abdominal pain. The SMT exhibited exophytic growth and measured 18×12×12 mm³. Over a two-year observation period, no changes in the tumor were noted. On further examination, she was diagnosed with intraperitoneal hemorrhage caused by the gastric SMT. At emergency surgery, torsion and necrosis of the SMT were seen, leading to a partial gastrectomy. The patient's postoperative course was uneventful, and she was discharged on the 7th postoperative day. Pathological examination with hematoxylin and eosin staining showed proliferation of spindle-shaped cells. Immunohistochemical analysis showed positivity for KIT and CD34, leading to a diagnosis of gastrointestinal stromal tumor (GIST). For small gastric GISTs exhibiting exophytic growth, surgical intervention should be considered due to the potential risk of stalk torsion.