A case of small intestinal GIST diagnosed by capsule endoscopy and single-balloon assisted enteroscopy

Abstract

A 50-year-old man was admitted to our hospital for investigation of anemia and a positive fecal occult blood test. No obvious pathology was seen on esophago-gastro-duodenoscopy and colonoscopy, and the patient was diagnosed with obscure gastrointestinal bleeding (OGIB) .
Capsule endoscopy showed an ulcerative lesion in the upper jejunum. Biopsies from the ulcer were taken by single-balloon assisted enteroscopy. Pathological findings were compatible with small intestinal gastrointestinal stromal tumor (GIST) , and partial jejunectomy was performed laparoscopically. Macroscopic examination of the resected specimen showed a tumor measuring 60 mm in diameter. Histopathologically, the tumor cells were spindle-shaped (HE staining) and KIT positive, and the final pathological diagnosis was high risk GIST.
Although the percentage of small intestinal tumors as the cause of OGIB is only 14%, the ratio of GIST is high in small intestinal tumors. It has previously been reported that 63% of small intestinal GIST diagnosed with balloon assisted enteroscopy are detected from OGIB. Examination of the small intestine should be performed in patients with OGIB while considering the potential presence of small intestinal tumors including GIST.