Abstract –
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of
the gastrointestinal tract.Ever since the classification of GIST as an entity distinct from
leiomyomas, leiomyosarcomas, etc., there has been an increased interest in defining their
imaging characteristics. It is estimated that approximately 5000-10,000 people are affected
per year by this tumor all over the world. Most GISTs are benign (70-80%). However, these
tumors have a spectrum ranging from benign to malignant lesions, depending on the anatomic
site, tumor size, and mitotic frequency. We report a case of multiple malignant GIST with
metastasis into Liver.
Keywords:
hepatic metastasis, gastrointestinal stromal tumour
Title:
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The term GIST defines a unique group of mesenchymal neoplasms
that are distinct from true smooth muscle and neural tumors.[1 ]Ever since the
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It is estimated that approximately
5000-10,000 people are affected per year by this tumor all over the world. Most GISTs are
benign (70-80%). However, these tumors have a spectrum ranging from benign to malignant
lesions, depending on the anatomic site, tumor size, and mitotic frequency.[2] We report a
case of malignant GISTs with metastasis into Liver
Case Presentation
A 45 yr old male was referred to our department for CT Scan of his abdomen. He complained
of abdominal pain and bleeding per rectum since 3 months. On examination he had diffuse
abdominal pain and perrectal examination was normal. The laboratory tests were also normal.
On performing CT scan there were multiple ill defined hetrogenous exophytic masses with
central necrosis abutting the jejunal loops and the caecum. The size of masses ranges from
approx. 7cm to 12 cm .On contrast administration, these lesions showed heterogeneous
peripheral enhancement(Figure 1 and 2). The caecum also showed significant wall thickening
with narrowing of the lumen. The liver showed multiple well defined
HISTORY OF PRESENT ILLNESS: This 46-year-old gentleman with past medical history significant only for degenerative disease of the bilateral hips, secondary to arthritis, presents to the emergency room after having had three days of abdominal pain. It initially started three days ago and was a generalized vague abdominal complaint. Earlier this morning, the pain localized and radiated to the right lower quadrant. He had some nausea without emesis. He was able to tolerate p.o. earlier around
ABDOMEN: The lung basis appeared unremarkable. The liver, spleen, gallbladder, adrenals, kidneys and pancreas and abdominal aorta appeared unremarkable. The bowels seen on the study appeared thickened. Dilated appendix seen constant with acute appendicitis. Osseous structures of the abdomen appeared unremarkable. No free air was seen.
small intestines. In this case, fortunately the patient was spared with a mild case and
HISTORY OF PRESENT ILLNESS: This 46-year old gentleman with past medical history significant only for degenerative disease of the bilateral hips, secondary to arthritis presents to the emergency room after having had 3 days of abdominal pain. It initially started 3 days ago and was a generalized vague abdominal complaint. Earlier this morning the pain localized and radiated to the right lower quadrant. He had some nausea without emesis. He was able to tolerate p.o earlier around 6am, but he now
T.B. is a 65-year-old retiree who is admitted to your unit from the emergency department (ED). On arrival you note that he is trembling and nearly doubled over with severe abdominal pain. T.B. indicates that he has severe pain in the right upper quadrant (RUQ) of his abdomen that radiates through to his mid-back as a deep, sharp boring pain. He is more comfortable walking or sitting bent forward rather than lying flat in bed. He admits to having had several similar bouts of abdominal pain in the last month, but “none as bad as this.” He feels nauseated but has not vomited, although he did vomit a week ago with a similar episode. T.B. experienced an acute onset of pain after eating fish and chips
History of Present Illness: The patient is a 27-year-old male complaining of right lower-quadrant abdominal pain, nausea, and
The patient complained of right lower quadrant pain and of feeling faint. Dr. O'Donnel documented a chief complaint, a brief history of present illness, and a systemic review of the gastrointestinal system and respiratory system. Dr. O'Donnel also documented a complete examination of all body systems, which included all required elements. Medical decision making was of moderate complexity.
History of Present Illness: The patient is a 27-year-old male complaining of right lower-quadrant abdominal pain, nausea, and
Thus allowing me to form a differential diagnosis and rule out certain causes, such as; constipation, and indigestion. Subsequently, the physical examination enabled me to confirm a diagnosis of acute abdomen. As the patient was not experiencing any worrying (red flag) symptoms associated with abdominal emergencies, such as; appendicitis or pancreatitis. However, I did forget certain aspects of the physical examination and had to be prompted by the MO. Although with more practice such incidence would be reduced.
It is rarely found in children older than 10. This type of cancer accounts for about 7% of childhood cancers.
DS is a 57-year-old white female whit a history of diverticulitis who presents to the clinic for an evaluation of abdominal pain. She stated that she began experiencing left lower quadrant pain last night that worsened through the night and into this morning. The pain is described as dull, occasionally cramping, rated 7/10 in severity. The patient also stated that this pain is similar to previous episodes of diverticulitis. The patient stated that she took Gas-X this morning with little relief. She was able to move her bowels yesterday and this morning, both reportedly normal. The patient denied any fever, chills, chest pain, shortness of breath, nausea, vomiting, diarrhea, melena, hematochezia, or any other symptoms. At this time, there were
Follicular tumors, on the other hand, grow only on one side of the gland. These tumors develop in the hormone-producing cells and account for 30% - 50% of all thyroid cancers (Thackery 1057). Medullary thyroid tumors account for 5% - 7% of all thyroid cancers, and are usually uncommon. Like papillary tumors, they grow on one or both sides of the gland. Anaplastic tumors, though extremely rare, develop on either side of the thyroid gland and spread rapidly to other parts of the body. It account for only 2% of all thyroid cancers but is the fastest growing, and most aggressive thyroid cancer type (Thackery 1057).
It is the most commonly seen cancerous tumor. Though it can affect dog of any breed, it is predominant in some breeds such as the Golden Retriever. Depending upon the location
According to a research, an overall 5 year survival rate is known to be an exceedingly positive, which is 70% of all cases. If the tumor is in a localized position and does not affect its surrounding tissues, the vitality of cases is 91%. 74% survival rate was recorded among patients with tumors that have grown out reach to connected lymph nodes and its surrounding tissues, while 48% chances of living for those with tumors that has developed to a distinct location from its origin. The figure may vary in the future because of the development of new medical treatments discovered.
Tumors are one of the most feared diseases of our time. Many people upon hearing the word “tumor” immediately resonate to the conclusion of it being cancer, which is not necessarily true. Tumors fall into to two main types, benign and malignant. Although they are considerably different in tissue invasion, their nature that makes them distinct and symptoms, they are also quite similar in the way they recur in the same location, growth size and their health risks.