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Laparoscopic total gastrectomy for multiple sporadic gastric gastrointestinal stromal tumors: report of a case

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Abstract

A 64-year-old man was admitted to our hospital with hematemesis. Emergency upper gastrointestinal endoscopy revealed bleeding from a submucosal tumor (SMT) in the antrum of the stomach, with two other SMTs at different sites. Based on his family history, we diagnosed familial multiple gastric gastrointestinal stromal tumors (GISTs) and performed laparoscopic total gastrectomy. Three distinct tumors were found: one in the fornix, one in the lesser curvature of the angle, and one in the antrum of the stomach. Microscopic examination of the resected specimens revealed different cytomorphologies, of the spindle and epithelioid type, as well as immunophenotypes in the tumors. Mutation analysis revealed different sites of mutation in c-kit and PDGFRA. No mutation was detected in the normal tissue of the stomach. These findings confirmed a diagnosis of multiple sporadic gastric GISTs. Thus, investigating germline mutation might assist in the preoperative diagnosis of multiple gastric GISTs.

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Acknowledgments

We thank Chihiro Watanabe for his critical review of the manuscript, Koichi Araki for excellent technical assistance, and Hideo Mishima for providing the sections from the sister of the patient.

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Authors and Affiliations

  1. Department of Surgery, Takatsuki Red Cross Hospital, 1-1-1 Abuno, Takatsuki, Osaka, 569-1096, Japan

    Akihisa Fujimoto, Toshihiro Kobayashi, Shigeki Uchida, You Ichinose, Tetsu Sasaoki & Kenzo Goto

  2. Department of Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan

    Hiroshi Okabe

Authors
  1. Akihisa Fujimoto
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  2. Toshihiro Kobayashi
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  3. Shigeki Uchida
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  4. You Ichinose
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  5. Tetsu Sasaoki
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  6. Kenzo Goto
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  7. Hiroshi Okabe
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Correspondence to Akihisa Fujimoto.

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Fujimoto, A., Kobayashi, T., Uchida, S. et al. Laparoscopic total gastrectomy for multiple sporadic gastric gastrointestinal stromal tumors: report of a case. Surg Today 42, 84–88 (2012). https://doi.org/10.1007/s00595-011-0011-x

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  • DOI: https://doi.org/10.1007/s00595-011-0011-x

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