A CASE OF GASTROINTESTINAL STROMAL TUMOR (GIST) IN WHICH HEMORRHAGIC SCINTIGRAPHY WAS USEFUL FOR DELAYED DIAGNOSIS

Abstract

A 64-year-old woman was admitted to the hospital because of repeated severe anemia of unknown origin for about 4 years. Upper gastrointestinal (GI) series. endoscopy, barium enema study, and lower GI endoscopy revealed no origin other than gastric ulcer and we could not make any diagnosis. In order to explor the bleeding site, 99 mTc-RBC hemorrhagic scintigraphy was performed and a tumor or the small intestine was suspected. Fluoroscopic examination of the small intestine, abdominal CT scan, and angiography of the superior mesenteric artery comfirmed a jejunal tumor. Endoscopic biopsy offered a diagnosis of leiomyoma of the jejunum. It was a 50×45mm well-demarcated tumor about 15cm distal from the Treitz' ligament. A partial resection of the small intestine was carried out and it was diagnosed as gastrointestinal stromal tumor (GIST) histologically. Thereafter no recurrence of anemia nor metastasis of the tumor has occurred.
It is thought that hemorrhagic scintigraphy is a useful method for unexplained exacerbations of anemia.