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A planar gastrointestinal stromal tumor replacing the proper muscle layer causing fecaloma and perforation in the sigmoid colon: a case report and literature review

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Abstract

A 72-year-old Japanese male with acute abdomen underwent emergency surgery for a preoperative diagnosis of stercoral colonic perforation of the sigmoid colon. A pathological examination revealed a proliferating spindle cell lesion that surrounded the perforation and replaced the muscularis propria without any mass formation. The spindle cells were positive for KIT and CD34 by immunohistochemistry, and somatic mutation of the c-kit gene was found using genomic DNA extracted from the lesion. We diagnosed the spindle cell lesion as a planar gastrointestinal stromal tumor (GIST). We speculate that perforation of the sigmoid colon in this case may be caused by the stasis of stool resulting from abnormal peristalsis of the lesional site. Two other similar cases have been reported in the literature, and showed good prognoses. Although their pathogenesis is unclear, planar GISTs should be considered as a possible cause of idiopathic or stercoral colonic perforation.

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References

  1. Hirota S, Isozaki K, Moriyama Y, et al. Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science. 1998;279:577–80.

    Article  CAS  PubMed  Google Scholar 

  2. Isozaki K, Hirota S. Gain-of-function mutations of receptor tyrosine kinases in gastrointestinal stromal tumors. Curr Genomics. 2006;7:469–75.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Hanada M, Takahashi Y, Ikeda K. Gastrointestinal stromal tumor (GIST) of the sigmoid colon presenting as megacolon with fecaloma: a hither undescribed presentationn caused by diffuse muscular infiltration by GIST. J Toyonaka Munic Hosp. 2003;4:83–9.

    Google Scholar 

  4. Agaimy A, Märkl B, Arnholdt H, et al. Sporadic segmental interstitial cell of cajal hyperplasia (microscopic GIST) with unusual diffuse longitudinal growth replacing the muscularis propria: differential diagnosis to hereditary GIST syndromes. Int J Clin Exp Pathol. 2010;3:549–56.

    CAS  PubMed Central  PubMed  Google Scholar 

  5. Yamashita D, Usami U, Toyosawa S, et al. A case of diffuse infiltrating gastrointestinal stromal tumor of sigmoid colon with perforation. Pathol Int. 2014;64:34–8.

    Article  CAS  PubMed  Google Scholar 

  6. Xue L, Qiu T, Song Y, et al. Long segmental hyperplasia of interstitial cells of Cajal with giant diverticulum formation. Int J Clin Exp Pathol. 2013;6:2989–96.

    PubMed Central  PubMed  Google Scholar 

  7. Shoji M, Yoshimitsu Y, Maeda T, et al. Perforated gastrointestinal stromal tumor (GIST) in a true jejunal diverticulum in adulthood: report of a case. Surg Today. 2013;. doi:10.1007/s00595-013-0732-0.

    Google Scholar 

  8. Falidas E, Mathioulakis S, Vlachos K, et al. Stercoral perforation of the sigmoid colon. A case report and brief review of the literature. G Chir. 2011;32:368–71.

    CAS  PubMed  Google Scholar 

  9. Tamai M, Satoh M, Tsujimoto A. Segmental muscular defects of the intestine: a possible cause of spontaneous perforation of the bowel in adults. Hum Pathol. 2013;44:2643–50.

    Article  PubMed  Google Scholar 

Download references

Disclosures

Conflict of Interest:

Goro Ueno, Tamaki Maeda, Ryoichi Arima, Hiroshi Oka and Seiichi Hirota declare that they have no conflict of interest.

Human/Animal Rights:

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008(5).

Informed Consent:

Informed consent was obtained from all patients for being included in the study.

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Correspondence to Tamaki Maeda.

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Ueno, G., Maeda, T., Arima, R. et al. A planar gastrointestinal stromal tumor replacing the proper muscle layer causing fecaloma and perforation in the sigmoid colon: a case report and literature review. Clin J Gastroenterol 7, 328–332 (2014). https://doi.org/10.1007/s12328-014-0514-2

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  • DOI: https://doi.org/10.1007/s12328-014-0514-2

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