SURGICAL MANAGEMENT OF DUODENAL GASTROINTESTINAL STROMAL TUMOR IN A YOUNG ADULT FEMALE PATIENT: A CASE REPORT

Abstract

Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms. They can arise anywhere in digestive tract in adults and only in fewer than 5% of cases can be located in duodenum. Case presentation: We report on a rare case of duodenal GIST in 32-year-old female patient with several comorbidities (extreme obesity, HTA, glucose intolerance) and previous left adrenalectomy. The tumor mass was located in D2 portion of duodenum involving the papilla of Vater, with diameter of 5 cm. It was diagnosed with upper GI endoscopy, abdominal US and CT scan and confirmed histologically as GIST. The optimal surgical approach in this case was pancreaticoduodenectomy (en bloc resection) due to location and size of the tumor and involving the adjacent anatomical structures. R0 resection was confirmed with negative surgical margins. Postoperative course was prolonged due to respiratory complications and present pancreatic fistula. The patient was discharged from hospital in good health condition. Conclusion: There is lack of consensus about appropriate surgical approach in these tumors, due to its rarity. Optimal surgical strategies for duodenal GISTs remain to be established.