EGIST: a Rare Tumor

KIT (CD117) Positive Huge Primary Malignant Extra Gastrointestinal Stromal Tumors (EGISTs) Arising From Jejunal Mesentery: A Rare Case Report

Tumors arising outside gastrointestinal systems are known as extra gastrointestinal stromal tumors (EGISTs). Outside gastrointestinal sites include the mesentery, omentum, peritoneum, pancreas, and liver. Our case highlights a rare occurrence of an EGIST in jejunal mesentery in a 45-year-old male with an asymptomatic large abdominal growth and weight loss. A contrast-enhanced multi-dimensional computed tomography scan showed a large heterogeneous mass in the left hypochondrium. lumbar, and paraumbilical regions. Later, the patient underwent surgical resection of the tumor along with the involved jejunal segment and small tumor masses in the mesentery. Histopathological examination reported a malignant EGIST of mesentery and invasion into the jejunum, further confirmed by immunohistochemistry (IHC) markers like CD117 and smooth muscle actin with a high proliferative index (Ki67). One should be aware that these are different from other malignancies arising from the mesentery. Their cell of origin is different and needs a specific type of treatment. The clinical history, radiological findings, histopathology, and IHC help in diagnosing especially when they are arising from unusual areas like jejunal mesentery. Surgical intervention and chemotherapy are mainstay treatments.

Curative intent treatment of late presented extragastrointestinal stromal tumor: two identical case reports with literature review

Gastrointestinal stromal tumors (GISTs) occurring outside the gastrointestinal tract are known as extragastrointestinal stromal tumors (EGIST). They share some common histopathologic and molecular characteristics. This report describes two female patients who were suspected of having a mesenteric GIST, but opted for surveillance rather than definitive treatment. Upon reassessment, both patients demonstrated increased tumor mass with no evidence of distant metastasis. The intraoperative findings confirmed the conclusion of clinical and imaging studies performed preoperatively and radical excisions were performed. Histopathological examination (spindle cell neoplasm) and immunohistochemistry (CD117) confirmed EGIST. Both patients underwent Imatinib therapy following surgery with no evidence of disease recurrence or metastasis upon follow up. Although sharing histologic features with GIST, EGIST frequently demonstrates distinct characteristics that facilitate the proper diagnosis and management of EGIST. Since it is a rare and aggressive disease with a poor outcome, early detection and curative surgical resection remains the mainstay of treatment.

Pelvic Gastrointestinal Stromal Tumor With Pulmonary Metastasis

Extragastrointestinal stromal tumors (EGISTs) comprise a small portion of gastrointestinal stromal tumors. Metastasis normally occurs to nearby organs. However, metastasis to the lungs is uncommon in EGISTs. Furthermore, recurrence of the EGIST in a new location years later has not been documented. We present this case to highlight this behavior of EGISTs in hopes to better understand this rare type of neoplasm.

An unexpected extra-gastrointestinal stromal tumor (E-GIST) on the jejunal mesentery

Extra-gastrointestinal stromal tumors (E-GIST) are group of soft tissue neoplasm, which originates from outside the gastrointestinal tract and comprises less than 5% of the total GIST. Most commonly, they originate from the omentum, mesentery, retroperitoneum or the solid organs like liver and the pancreas. E-GIST arising from the sac of the jejunal mesentery, and mimicking preoperatively as a colonic neoplasm is very rare. Here we report an interesting case of a 55-year-old male, who presented with pain abdomen for 4 months duration. Contrast enhanced computed tomography was suggestive of right colonic neoplasm. Intraoperatively, to our surprise, the tumor was seen arising from the mesentery of the jejunum and was resected.