Journal of Medical Ultrasonics

, Volume 43, Issue 1, pp 107–111 | Cite as

A report of three cases of exophytic gastrointestinal stromal tumor detected by transabdominal ultrasound

  • Takaaki Sugihara
  • Masahiko Koda
  • Takashi Tanimura
  • Manabu Yoshida
  • Yoshikazu Murawaki
Case Report


Gastrointestinal stromal tumors (GISTs) are the most common submucosal tumors of the stomach. GISTs are often detected by esophagogastroduodenal endoscopy (EGD). However, the exophytic GIST type is relatively rare and difficult to detect by EGD. Most exophytic GISTs found are large and symptomatic. We present three cases with exophytic GISTs less than 5 cm in diameter detected by transabdominal ultrasound (TUS). All patients were asymptomatic and TUS revealed hypoechoic solid masses 2–3 cm in diameter between the stomach and left lobe of the liver. In contrast, no tumor in the stomach was detected by esophagogastroduodenal endoscopy. Endoscopic ultrasound and enhanced CT showed gastric tumors protruding outward. All three cases underwent partial gastrectomy, and the excised tumor was diagnosed as low-grade GIST. In conclusion, TUS can be a starting point for diagnosing exophytic GISTs of the stomach.


Gastrointestinal stromal tumor Exophytic type Transabdominal ultrasound 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Human rights statements and informed consent

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 was obtained from all patients for being included in the report.


  1. 1.
    Laurini JA, Carter JE. Gastrointestinal stromal tumors: a review of the literature. Arch Pathol Lab Med. 2010;134:134–41.PubMedGoogle Scholar
  2. 2.
    Machairas A, Karamitopoulou E, Tsapralis D, et al. Gastrointestinal stromal tumors (GISTs): an updated experience. Dig Dis Sci. 2010;55:3315–27.PubMedCrossRefGoogle Scholar
  3. 3.
    Kawaguchi M, Sanji T, Moriyasu F, et al. Clinical treatment of GIST-incidence of GIST among patients with submucosal tumors and its clinical treatment. I to Cho (Stomach and Intestine). 2001;36:1137–45 (in Japanese).Google Scholar
  4. 4.
    Ding G, Yang J, Cheng S, et al. A rare case of rapid growth of exophytic gastrointestinal stromal tumor of the stomach. Dig Dis Sci. 2005;50:820–3.PubMedCrossRefGoogle Scholar
  5. 5.
    Watanabe T, Segami K, Sasaki T, et al. A rare case of concomitant huge exophytic gastrointestinal stromal tumor of the stomach and Kasabach–Merritt phenomenon. World J Surg Oncol. 2007;5:59.PubMedPubMedCentralCrossRefGoogle Scholar
  6. 6.
    Naitoh I, Okayama Y, Hirai M, et al. Exophytic pedunculated gastrointestinal stromal tumor with remarkable cystic change. J Gastroenterol. 2003;38:1181–4.PubMedCrossRefGoogle Scholar
  7. 7.
    Booka E, Takahashi T, Tokizawa K, et al. A case of late lymph node metastasis after three endoscopic mucosal resections of intramucosal gastric cancers. World J Surg Oncol. 2014;12:339.PubMedPubMedCentralCrossRefGoogle Scholar
  8. 8.
    Humphris JL, Jones DB. Subepithelial mass lesions in the upper gastrointestinal tract. J Gastroenterol Hepatol. 2008;23:556–66.PubMedCrossRefGoogle Scholar
  9. 9.
    Hasegawa T, Matsuno Y, Shimoda T, et al. Gastrointestinal stromal tumor: consistent CD117 immunostaining for diagnosis, and prognostic classification based on tumor size and MIB-1 grade. Hum Pathol. 2002;33:669–76.PubMedCrossRefGoogle Scholar
  10. 10.
    Nishida T, Hirota S, Yanagisawa A, et al. GIST Guideline Subcommittee. Clinical practice guidelines for gastrointestinal stromal tumor (GIST) in Japan: English version. Int J Clin Oncol. 2008;13:416–30.PubMedCrossRefGoogle Scholar
  11. 11.
    Wronski M, Cebulski W, Slodkowski M, et al. Gastrointestinal stromal tumors: ultrasonographic spectrum of the disease. J Ultrasound Med. 2009;28:941–8.PubMedGoogle Scholar
  12. 12.
    Sanne M, van der Zwan SM, DeMatteo RP. Gastrointestinal stromal tumor: 5 years later. Cancer. 2005;104:1781–8.CrossRefGoogle Scholar
  13. 13.
    Polkowski M, Palucki J, Butruk E. Transabdominal ultrasound for visualizing gastric submucosal tumors diagnosed by endosonography: can surveillance be simplified? Endoscopy. 2002;34:979–83.PubMedCrossRefGoogle Scholar
  14. 14.
    Futagami K, Hata J, Haruma K, et al. Extracorporeal ultrasound is an effective diagnostic alternative to endoscopic ultrasound for gastric submucosal tumours. Scand J Gastroenterol. 2001;36:1222–6.PubMedCrossRefGoogle Scholar

Copyright information

© The Japan Society of Ultrasonics in Medicine 2015

Authors and Affiliations

  • Takaaki Sugihara
    • 1
  • Masahiko Koda
    • 1
  • Takashi Tanimura
    • 2
  • Manabu Yoshida
    • 3
  • Yoshikazu Murawaki
    • 1
  1. 1.Division of Medicine and Clinical Science, Department of Multidisciplinary Internal MedicineTottori University Faculty of MedicineYonagoJapan
  2. 2.Department of GastroenterologyMatsue Municipal HospitalMatsueJapan
  3. 3.Department of Clinical LaboratoryMatsue Municipal HospitalMatsueJapan

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