Abstract
We report a 7-year-old boy presenting with an acute upper gastrointestinal (GI) haemorrhage subsequently diagnosed to have a very rare duodenal gastrointestinal stromal tumour (GIST). Endoscopy, pertechnetate and red cell scans were negative. Abdominal US detected a 17-mm mass lesion of the third part of the duodenum. This was confirmed on CT and shown to be hypervascular on selective angiography. At laparotomy, a 20-mm submucosal duodenal lesion was found associated with mucosal ulceration. Immunohistochemical analysis revealed it to be positive for CD117 (c-KIT protein) consistent with a GIST. We emphasize the importance of a thorough abdominal US examination in children with GI haemorrhage and the consideration of GIST in the diagnosis after the common causes have been excluded.
Similar content being viewed by others
References
Miettinen M, Lasota J (2001) Gastrointestinal stromal tumors—definition, clinical, histological, immunohistochemical and molecular genetic features and differential diagnosis. Virchows Arch 438:1–12
Skinner MA, Plumley DA, Grosfeld JL, et al (1994) Gastrointestinal tumors in children: an analysis of 39 cases. Ann Surg Oncol 1:283–289
McGrath PC, Neifeld JP, Kay S, et al (1988) Principles in the management of pediatric intestinal leiomyosarcomas. J Pediatr Surg 23:939–941
Lau S, Tam KF, Kam CK, et al (2004) Pictorial review. Imaging of gastrointestinal tumour (GIST). Clin Radiol 59:487–498
Li P, Wei J, West AB, et al (2002) Epitheloid gastrointestinal stromal tumour of the stomach with liver metastases in a 12-year-old girl: aspiration cytology and molecular study. Pediatr Dev Pathol 5:386–394
Kerr JZ, Hicks MJ, Nuchtern JG, et al (1999) Gastrointestinal autonomic nerve tumours in the paediatric population. A report of 4 cases and a review of the literature. Cancer 85:220–230
De Matteo RP, Lewis JJ, Leung D, et al (2000) Two hundred gastrointestinal stromal tumours: recurrence patterns and prognostic patterns for survival. Ann Surg 231:51–58
Joensuu H, Roberts PJ, Sarlomo-Rikala M, et al (2001) Effect of the tyrosine kinase inhibitor STI1571 in a patient with a metastatic gastrointestinal stromal tumour. N Engl J Med 344:1052–1056
Miettinen M, Majidi M, Lasota J (2002) Pathology and diagnostic criteria of gastrointestinal stromal tumors (GISTs): a review. Eur J Cancer 38:S39–S51
Fletcher CD, Berman JJ, Corless C, et al (2002) Diagnosis of gastrointestinal stromal tumours: a consensus approach. Hum Pathol 33:459–465
Demetri GD, Mehren MV, Blanke CD, et al (2002) Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med 347:472–480
Dematteo RP, Maki RG, Antonescu C, et al (2003) Targeted molecular therapy for cancer: the application of STI571 to gastrointestinal stromal tumour. Curr Probl Surg 40:144–193
Acknowledgements
We acknowledge the support of Dr. J.M.E. Kirk, Darrent Valley Hospital, Dartford, UK.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Hughes, J.A., Cook, J.V., Said, A. et al. Gastrointestinal stromal tumour of the duodenum in a 7-year-old boy. Pediatr Radiol 34, 1024–1027 (2004). https://doi.org/10.1007/s00247-004-1298-1
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00247-004-1298-1