A case with melena as the first diagnostic clue to a duodenal gastrointestinal stromal tumor

Abstract

A 66-year-old woman was admitted to the hospital complaining of melena. An urgent esophagogastroduodenoscopy (EGD) was performed, which revealed an abnormal opening in the horizontal segment of the duodenum with bleeding. Abdominal enhanced computed tomography (CT) showed a tumor measuring about 90 mm in diameter arising from the horizontal segment of the duodenum. There was no lymph node swelling or evidence of metastasis. On immunohistochemical analysis of the biopsy specimen, the tumor was found to show positive staining for c-kit and CD34. Based on the findings, a definitive diagnosis of duodenal gastrointestinal stromal tumor (GIST) was made, and partial resection of the horizontal segment of the duodenum was performed for complete resection of the tumor. The postoperative course was uneventful. The patient was initiated on treatment with oral imatinib mesylate (400mg/day) .