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A clinically-occult gastrointestinal stromal tumor in a Meckel's diverticulum presenting as hollow organ perforation

Yueh-Hung Chou1, Chao-Chiang Tu, Chun-Chieh Huang

  • 1Department of Anatomical Pathology, Far Eastern Memorial Hospital, Taipei, Taiwan.

Chang Gung Medical Journal
|April 12, 2012
PubMed

Insights

A rare gastrointestinal stromal tumor (GIST) ruptured within a Meckel's diverticulum, causing organ perforation. This case highlights the risk of occult neoplasms in asymptomatic Meckel's diverticula, questioning observation-only management.

Area of Science:

  • Gastroenterology
  • Surgical Pathology
  • Oncology

Background:

  • Meckel's diverticulum is the most common congenital anomaly of the gastrointestinal tract.
  • Neoplasms are rare but serious complications of Meckel's diverticulum.
  • Gastrointestinal stromal tumors (GISTs) are a type of mesenchymal tumor that can arise in the gastrointestinal tract.

Observation:

  • A case of a ruptured GIST within a Meckel's diverticulum presenting as hollow organ perforation in a 76-year-old woman.
  • This represents the sixth reported case of a perforated GIST within a Meckel's diverticulum.
  • The diverticular neoplasm was clinically occult due to an unusual tumor configuration.

Findings:

  • Ruptured GIST in Meckel's diverticulum can present as hollow organ perforation.
  • Clinically occult diverticular neoplasms may be missed with observation-only management of asymptomatic Meckel's diverticula.
  • The unusual tumor configuration contributed to the occult nature of the neoplasm in this case.

Implications:

  • The management of asymptomatic Meckel's diverticula is controversial.
  • Pure observation of asymptomatic Meckel's diverticula may lead to undertreatment of potentially occult neoplasms.
  • Further evaluation is needed regarding the role of prophylactic diverticulectomy for Meckel's diverticula.

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