A CASE OF STROMAL TUMOR OF THE ILEUM

Abstract

We experienced a case of malignant stromal tumor of the ileum. A 59-yer-old women complaining of abdominal pain, abdominal fullness and vomiting was referred to the hospital with a diagnosis of intestinal obstruction. She was treated by a long tube to release the obstruction. Thereafter, upper gastrointestinal series, ultasonography, CT, magnetic resonance imaging, and angiography revealed a tumor which was 11cm in diameter, well-delineated and hypervascular, and developed extramurally at the ileum. Under the diagnosis of leiomyosarcoma, a partial resection of the ileum including the tumor was performed.
Histologically, the tumor was mainly composed of proliferated spindle cells and partially epithelioid cells which have mitotic figure 6/10 high power field. Immunohistologically, the tumor was not stained for α-smoogh muscle actin, desmin and S-100 protein, but for NSE and CD34. Though the tumor was positive for NSE, the differentiation to the nerve was not found. Therefore, it was diagnosed as uncommitted type of malignant gastrointestinal stromal tumor (GIST) of the ileum. GIST is a relatively new concept, and hence, further studies on the prognosis, mode of recurrence, frequency, and differences in imaging methods according to sub-classification of GIST would be needed.