Synchronous occurrence of ileal stromal tumor (GIST) and colonic adenocarcinoma: a case report

INTRODUCTION

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract. There is an increasing number of literature reports on synchronous occurrence of gastrointestinal stromal tumors and another malignancy of distinct etiology and evolution. The most reported cases include gastric synchronous occurrence of gastrointestinal stromal tumors and adenocarcinoma and gastric gastrointestinal stromal tumors and colonic adenocarcinoma.

CASE REPORT

We present a case of a 77-old female, with synchronous cecal moderately differentiated adenocarcinoma in Stage IIA according to the TNM classification and ileal spindle cell type GIST with low malignant potential, positive for c-Kit, CD34, vimentin, Actin, and negative for S100.

CONCLUSION

The synchronous occurrence of small bowel gastrointestinal stromal tumors and other primary gastrointestinal malignancies has been rarely reported. There is a need of further investigations to identify the relationship between gastrointestinal stromal tumors and colorectal cancers.

Small bowel diverticulosis as a cause of ileus: a case report

Small bowel diverticulosis (SBD) is a rare condition. In most cases it is asymptomatic, but sometimes it can be manifested with chronic non-specific or acute symptoms. Because of the absence of pathognomonic signs and symptoms and truly reliable diagnostic tests, SBD is hard to diagnose and this is usually done incidentally by radiographic examination or during laparatomy. For uncomplicated patients, those with chronic abdominal pain, syndromes of malabsorption related to jejunoileal diverticulosis, bacterial overgrowth or an episode of intestinal obstruction, as in our case, conservative management is the initial option for treatment. A case of a patient with obstructive symptoms of the gastrointestinal tract due to SBD that was conservatively treated and had a positive outcome is presented.

Giant retroperitoneal liposarcoma: а case report

BACKGROUND

Liposarcoma is a neoplasm of mesodermic origin derived from adipose tissue and represents the most frequent histopathological variety of the retroperitoneum. Retroperitoneal liposarcoma may grow to a large size without symptoms. Approximately 20% of the tumours are >10 cm at the time of diagnosis and may reach extremely giant dimensions.

CASE PRESENTATION

We present the case of a 58-year-old woman with a giant retroperitoneal liposarcoma. The patient presented at our clinic with diffuse abdominal pain and enormous abdominal distension. She had swellings and redness of the right leg. CT scan revealed a 50×25 cm sized enhancing soft mass. Ultrasound guided biopsy was negative for the presence of malignant cells. A double "J" ureteral stent was placed in the right ureter. We performed surgery with complete resection of the tumorous mass without multiorgan resection and with macroscopic free margins. A well differentiated, lipoma-like subtype of retroperitoneal liposarcoma, weighing 13.4 kg, was diagnosed in the histopathological report. At 6 months after surgery a new CT scan was done and there was no evidence of recurrence. Currently, after 12 months of follow-up, the patient is asymptomatic and disease free.

CONCLUSION

Surgery is the gold standard for treatment of retroperitoneal liposarcomas, well differentiated retroperitoneal liposarcomas, that have a minimal metastatic potential. It is preferable to place a ureteral stent before surgery for minimizing the risk of intraoperative lesions of ureters. Symptoms in lower extremities, such as swelling, redness and others, that are due to compression in the retroperitoneum by giant tumours, can disappear after their surgical removal.