A case of gastrointestinal stromal tumor deviation that met the risk classification after 3 -year follow up

Abstract

X-ray examination for gastric cancer screening revealed a smooth-surface elevated lesion, about 25mm in size, at the greater curvature side of the gastric fornix in a 54-year-old man. Endoscopy showed a gastric SMT of the same size at the same area. The lesion presented as homogeneous low attenuated enhancement on abdominal CT with contrast medium injected. Three years later, X-ray examination for gastric cancer screening revealed the lesion had increased in size to about 40mm. By endoscopy, several areas of small erosions were found at the surface of the lesion. Biopsy was performed and showed irregular tumor cells with KIT, CD34 strong positive and α-SMA positive by immunohistological staining and finally a GIST was diagnosed. EUS showed a comparatively homogeneously low echoic mass located in the 4th layer. On abdominal CT with contrast medium injected, an area of high attenuated enhancement was found in the lesion. Surgical resection was performed. And the pathological diagnosis was a high-grade GIST.