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Duodenal stromaltumor detected by CT-enteroclysis
H Ashkzaran1, K Coenegrachts, L Steyaert
1Dpt of Radiology, AZ St.-Jan AV, Bruges.
Summary
Gastro-intestinal stromal tumors (GISTs) can cause gastro-intestinal bleeding. A CT-enteroclysis identified a duodenal GIST missed by other diagnostic methods in a young man with recurrent bleeding.
Area of Science:
- Gastroenterology
- Oncology
- Diagnostic Imaging
Background:
- Gastro-intestinal stromal tumors (GISTs) are rare mesenchymal neoplasms.
- GISTs commonly manifest as gastro-intestinal bleeding, abdominal pain, weight loss, nausea, and vomiting.
- Diagnostic challenges exist for GISTs, particularly those with submucosal origins.
Observation:
- A young male patient presented with recurrent gastro-intestinal bleeding.
- Initial investigations including gastroscopy, coloscopy, ectopic gastric mucosa scan, and computed tomography yielded negative results.
- A subsequent CT-enteroclysis revealed a well-circumscribed 15 mm submucosal tumoral mass in the duodenum.
Findings:
- Microscopic examination of the duodenal mass confirmed the diagnosis of a gastro-intestinal stromal tumor.
- CT-enteroclysis proved crucial in detecting the submucosal GIST after other modalities failed.
- The case highlights the potential for GISTs to present insidiously with negative findings on standard endoscopic and imaging evaluations.
Implications:
- This case underscores the importance of advanced imaging techniques like CT-enteroclysis in diagnosing GISTs when conventional methods are inconclusive.
- Accurate and timely diagnosis of GISTs is critical for appropriate management and improved patient outcomes.
- Further research into optimal diagnostic strategies for submucosal gastro-intestinal tumors is warranted.
