Abstract
A 65-year-old female had undergone endoscopic examination on a regular basis for about 10 years at another clinic due to the diagnosis of liver cirrhosis and esophageal varices. Endoscopic examination had revealed no abnormal findings in the stomach until September 2001. In April 2002, she developed an epigastric pain, and underwent endoscopic examination. It revealed lower esophageal varices and an elevated lesion with deep ulceration at the cardia, and she was referred to our clinic. Endoscopic ultrasonography demonstrated a tumor 6 cm in diameter with an internal heterogeneous echo pattern at the fornix, which seemed to derive from the fourth layer of the gastric wall. Concurrently performed endoscopic biopsy led to the diagnosis of a gastrointestinal stromal tumor (GIST) , and total gastrectomy with splenectomy was done. The tumor was 8×6 cm in size and diagnosed pathohistologically as an uncommitted type GIST. There was no lymphatic metastasis. In summary, this is a case report of a GIST that rapidly grew to 8 cm in diameter with ulceration in six months. This case suggests that even a submucosal tumor may grow rapidly in a shortperiod of time and must be followed-up cautiously.
