Skip to main content


Log in

A case of a stomach gastrointestinal stromal tumor with extremely predominant cystic formation

  • Case Report
  • Published:
Clinical Journal of Gastroenterology Aims and scope Submit manuscript


A 79-year-old male was referred to the hospital with a history of abdominal discomfort. Abdominal computed tomography revealed a cystic tumor with irregular wall thickness, approximately 50 mm in diameter, along the lesser curvature of the gastric body. Magnetic resonance imaging visualized the mass as signal-hyperintense on T2-weighted imaging. Esophagogastroduodenoscopy showed a submucosal tumor with normal mucosa. Surgery was performed and the 60 × 50 × 50 mm mass was resected. The resected tumor comprised cystic and solid regions; the cystic region was filled by light bloody serous fluid. On histological examination, a solid region of the resected tumor showed a spindle-cell appearance. The diagnosis was gastric gastrointestinal stromal tumor (GIST) with predominant cystic formation. GISTs are usually solitary tumors, but in this case the tumor demonstrated extremely predominant cystic formation. Lesions with a hemorrhage or necrosis may form large cystic spaces. GISTs may show extensive cystic changes in response to tyrosine kinase inhibitor treatment; however, this patient had not undergone any such treatment before diagnosis. This represents an interesting case of a gastric GIST with predominant cystic formation occupying most of the tumor volume. Care should be taken to differentiate between GISTs and actual intra-abdominal cystic lesions.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others


  1. Park J, Rubinas TC, Fordham LA, Phillips JD. Multifocal gastrointestinal stromal tumor (GIST) of the stomach in an 11-year-old-girl. Pediatr Radiol. 2006;36:1212–4.

    Article  PubMed  Google Scholar 

  2. Osada T, Nagahara A, Kodani T, et al. Gastrointestinal stromal tumor of the stomach with a giant abscess penetrating the gastric lumen. World J Gastroenterol. 2007;13:2385–7.

    Article  PubMed Central  PubMed  Google Scholar 

  3. Yang F, Long J, Di Y, et al. A giant cystic lesion in the epigastric region. Pancreatic malignant gastrointestinal stromal tumour (GIST). Gut. 2008;57:1494.

    CAS  PubMed  Google Scholar 

  4. Cruz RJ Jr, Vincenzi R, Ketzer BM, et al. Spontaneous intratumoral bleeding and rupture of giant gastric stromal tumor (>30 cm) in a young patient. World J Surg Oncol. 2008;6:76.

    Article  PubMed Central  PubMed  Google Scholar 

  5. Harindhanavudhi T, Tanawuttiwat T, Pyle J, et al. Extra-gastrointestinal stromal tumor presenting as hemorrhagic pancreatic cyst diagnosed by EUS-FNA. JOP. 2009;10:189–91.

    PubMed  Google Scholar 

  6. Takahashi R, Nagayama S, Mori Y, et al. A large cystic gastrointestinal stromal tumor of the rectum in the retrorectal space. Int J Clin Oncol. 2010;15:601–7.

    Article  PubMed  Google Scholar 

  7. Yu CC, Wu CC, Hwang JI, et al. Thick calcification from a GIST of the stomach penetrating into pericolic soft tissue–report of a case. World J Surg Oncol. 2011;9:45.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Ide Y, Tamai M, Hirota S, et al. A case report of huge abdominal recurrent tumor of small intestinal GIST after 15 years from the operation with primary lesion. Gan To Kagaku Ryoho. 2011;38(12):2208–10 (In Japanese).

    PubMed  Google Scholar 

  9. Notani H, Kawamura T, Sato T, et al. A case of a giant gastrointestinal stromal tumor of the stomach with extramural growth. Gan To Kagaku Ryoho. 2013;40:2179–81 (In Japanese).

    PubMed  Google Scholar 

  10. Shoji M, Yoshimitsu Y, Maeda T. Perforated gastrointestinal stromal tumor (GIST) in a true jejunal diverticulum in adulthood: report of a case. Surg Today. 2014;44:2180–6.

    Article  PubMed  Google Scholar 

  11. Zhu CC, Liu Y, Zhao G. Exophytic gastrointestinal stromal tumor with cystic changes: a case report. Oncol Lett. 2014;7:1427–9.

    PubMed Central  PubMed  Google Scholar 

  12. de AP Hansen C, José FF, Caluz NP, et al. Gastrointestinal stromal tumor (GIST) mistaken for pancreatic pseudocyst––case report and literature review. Clin Case Rep. 2014;2:197–200.

    Article  Google Scholar 

  13. Ambrosio MR, Rocca BJ, Mastrogiulio MG, et al. Cystic gastrointestinal stromal tumors of the pancreas simulating cystoadenocarcinoma. Report of three cases and short review of the literature. Histol Histopathol. 2014;29:1583–91.

    CAS  PubMed  Google Scholar 

  14. Seow-En I, Seow-Choen F, Lim TK et al. Primary omental gastrointestinal stromal tumour (GIST) presenting with a large abdominal mass and spontaneous haemoperitoneum. BMJ Case Rep. 2014. doi:10.1136/bcr-2014-205528.

  15. Gu M, Ghafari S, Nguyen PT, et al. Cytologic diagnosis of gastrointestinal stromal tumors of the stomach by endoscopic ultrasound-guided fine-needle aspiration biopsy: cytomorphologic and immunohistochemical study of 12 cases. Diagn Cytopathol. 2001;25:343–50.

    Article  CAS  PubMed  Google Scholar 

  16. Levy AD, Remotti HE, Thompson WM, et al. Gastrointestinal stromal tumors: radiologic features with pathologic correlation. Radiographics. 2003;23:283–304.

    Article  PubMed  Google Scholar 

  17. Chourmouzi D, Sinakos E, Papalavrentios L, et al. Gastrointestinal stromal tumors: a pictorial review. J Gastrointestin Liver Dis. 2009;18:379–83.

    PubMed  Google Scholar 

  18. Fletcher CD, Berman JJ, Corless C, et al. Diagnosis of gastrointestinal stromal tumors: a consensus approach. Hum Pathol. 2002;33:459–65 (Fletcher classification system).

    Article  PubMed  Google Scholar 

  19. Miettinen M, Lasota J. Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol. 2006;23:70–83 (Miettinen’s classification system).

    Article  PubMed  Google Scholar 

  20. Joensuu H. Risk stratification of patients diagnosed with gastrointestinal stromal tumor. Hum Pathol. 2008;39:1411–9 (Joensuu classification system).

    Article  PubMed  Google Scholar 

  21. Nishida T, Hirota S, Yanagisawa A, et al. Clinical practice guidelines for gastrointestinal stromal tumor (GIST) in Japan: English version. Int J Clin Oncol. 2008;13:416–30.

    Article  PubMed  Google Scholar 

Download references


Conflict of Interest:

Hiroshi Okano, Tomomasa Tochio, Daisuke Suga, Hiroaki Kumazawa, Yoshiaki Isono, Hiroki Tanaka, Shimpei Matsusaki, Tomohiro Sase, Tomonori Saito, Katsumi Mukai, Akira Nishimura, Youichirou Baba and Tetsuya Murata declare that they have no conflict of interest.

Author information

Authors and Affiliations


Corresponding author

Correspondence to Hiroshi Okano.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Okano, H., Tochio, T., Suga, D. et al. A case of a stomach gastrointestinal stromal tumor with extremely predominant cystic formation . Clin J Gastroenterol 8, 197–201 (2015).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: