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[Acute rectal bleeding from malignant stromal tumor]
Oscar Lifschitz1, Nadya Ziv-Sokolovsky, Uriel Ben-Aharon
1Departments of Surgery and Pathology, Kaplan Medical Center, Rehovot.
Harefuah
|January 22, 2003
Summary
A rare malignant rectal stromal tumor presented with acute bleeding, requiring transfusion. Despite surgery and chemotherapy, the patient developed widespread metastases and died 7 months post-operation.
Area of Science:
- Gastroenterology
- Oncology
- Surgical Pathology
Background:
- Rectal stromal tumors are rare, often presenting with symptoms like bleeding, pain, constipation, or obstruction.
- Malignant gastrointestinal stromal tumors (GISTs) require prompt diagnosis and management due to their potential for aggressive behavior.
Observation:
- A case of a 61-year-old female with acute rectal bleeding due to a malignant rectal stromal tumor.
- Clinical presentation included significant bleeding necessitating blood transfusion.
- Preoperative imaging revealed a large rectal tumor with adjacent tissue extension.
Findings:
- Needle biopsy suggested gastrointestinal stromal tumor (GIST).
- Histological examination confirmed a spindle cell GIST with mucosal invasion, extensive necrosis, and high mitotic activity.
- Tumor cells expressed CD34 and smooth muscle actin, but were negative for desmin and S-100 protein.
Implications:
- This case highlights an uncommon clinical presentation of a rare rectal malignancy.
- Early detection and aggressive treatment strategies are crucial for managing malignant rectal stromal tumors.
- The aggressive nature and metastatic potential of this GIST underscore the need for continued research into effective therapies.