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Ruptured gastrointestinal stromal tumors: radiologic findings in six cases
M F Cegarra-Navarro1, M A Corral de la Calle, E Girela-Baena
1Department of Radiology, Hospital Morales Meseguer, Avenida Marqués de los Vélez, S/N, CP, 30008 Murcia, Spain. josepaki@eresmas.com
Abdominal Imaging
|April 19, 2005
Summary
Rupture of gastrointestinal stromal tumors (GISTs) can cause hemoperitoneum. Imaging findings of heterogeneous, laminated tumors with ascites suggest GIST rupture, a critical diagnosis for prompt intervention.
Area of Science:
- Gastroenterology
- Oncology
- Radiology
Background:
- Gastrointestinal stromal tumors (GISTs) are common mesenchymal tumors expressing c-KIT (CD 117).
- Tumor rupture with hemoperitoneum is an infrequent but serious complication of GISTs.
Purpose of the Study:
- To evaluate the clinical and radiologic features of ruptured GISTs.
- To identify imaging characteristics indicative of GIST rupture.
Main Methods:
- Retrospective review of 23 GIST patients' records (1999-2004).
- Analysis of clinical history, imaging (ultrasound, CT), and pathology.
Main Results:
- Five primary GIST ruptures (four gastric, one jejunal) and one metastatic rupture observed.
- Imaging showed heterogeneous, laminated/whirled tumors with echogenic/dense ascites.
- No correlation between malignancy histology and rupture; mortality rate was 40% in ruptured primary cases.
Conclusions:
- Heterogeneous tumors with laminated/whirled appearance and ascites suggestive of hemoperitoneum should raise suspicion for ruptured GIST.
- Prompt diagnosis and intervention are crucial for managing this complication.
