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Diagnosis of Hirschsprung's Disease by Immunostaining Rectal Suction Biopsies for Calretinin, S100 Protein and Protein Gene Product 9.5
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[A Case of Small Intestinal GIST Diagnosed by Intussusception].

Takafumi Watanabe1, Yuji Sugiyama, Hideaki Kawakita

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Gan to Kagaku Ryoho. Cancer & Chemotherapy
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A 34-year-old female presented with epigastric pain, leading to the diagnosis of a low-risk gastrointestinal stromal tumor (GIST). Emergency surgery was required due to intussusception caused by the GIST.

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Area of Science:

  • Gastroenterology
  • Surgical Oncology
  • Pathology

Background:

  • A 34-year-old female presented with epigastric pain.
  • Initial abdominal CT revealed a small intestinal tumor (30 mm) with contrast enhancement.

Observation:

  • Sudden onset of severe abdominal pain led to emergency surgery.
  • CT demonstrated small intestinal intussusception, necessitating resection of a 55 cm jejunal segment.
  • The resected specimen contained a 25 mm submucosal tumor at the intussusception apex.

Findings:

  • Pathological examination revealed a spindle cell proliferation originating from the muscularis propria.
  • Immunohistochemical analysis showed KIT-positive, CD34, S-100, and α-SMA-negative staining, confirming a gastrointestinal stromal tumor (GIST).
  • Low risk of recurrence was determined based on <5 nuclear divisions per 50 visual fields.

Implications:

  • This case highlights the potential for GISTs to cause acute abdominal emergencies like intussusception.
  • Early diagnosis and surgical intervention are crucial for managing GIST-induced complications.
  • Adherence to follow-up guidelines is essential for monitoring low-risk GIST patients.