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Revista de la Facultad de Medicina Humana

English Title

Tumor del estroma gastrointestinal (GIST) en yeyuno

Keywords

Gastrointestinal stromal tumor, cKit/CD117, midgastrointestinal hemorrhage

English Keywords

Tumor del estroma gastrointestinal, cKit/CD117, hemorragia digestiva media

Abstract

Gastrointestinal stromal tumors (GIST) are mesenchymal neoplasms that represent less than 3% of gastrointestinal neoplasms, with an incidence of 1 to 2 cases per hundred thousand inhabitants. It originates more frequently in the stomach and small intestine and is characterized by the expression of the tyrosine kinase growth factor receptor, CD117. Therefore, its diagnosis requires an immunohischemical study to rule it out from other mesenchymal tumors. However, enteroscopic imaging and analysis of the biopsy may suggest a preoperative diagnosis of probable GIST. The case of a 62-year-old woman with rectorrhagia and recurrent anemia caused by mid-intestinal bleeding observed by capsule endoscopy is reported. Enteroscopy revealed a subepithelial ulcerated lesion in the proximal jejunum, and a biopsy was taken, the anatomopathological study of which suggested a gastrointestinal stromal tumor. The biopsy sample subjected to immunohistochemical studies confirms the suspicion of a cKit/CD117-positive GIST tumor. Surgical resection of the tumor with dimensions 4.2x3 cm is performed. After surgery, the patient was stable and under clinical follow-up until she was discharged. Clinical finding

English Abstract

Los tumores del estroma gastrointestinal (GIST) son neoplasias mesenquimales que representan menos del 3% de las neoplasias gastrointestinales, con una incidencia de 1 a 2 casos por cien mil habitantes. Se origina con mayor frecuencia en el estómago e intestino delgado y tiene como característica la expresión del receptor de factor de crecimiento de tirosina kinasa, CD117, por lo tanto, su diagnóstico requiere de un estudio inmunohisquímico para descartarlo de otros tumores mesenquimales. Sin embargo, el estudio de imagen por enteroscopia y el análisis de la biopsia puede sugerir un diagnóstico preoperatorio de probable GIST. Se reporta el caso de una mujer de 62 años con rectorragia y anemia recurrente causada por hemorragia intestinal media observada por capsula endoscópica. En la enteroscopia se evidencia una lesión ulcerada subepitelial en yeyuno proximal, y se procede a tomar biopsia cuyo estudio anatomopatológico sugiere tumor del estroma gastrointestinal. La muestra de biopsia sometida a estudios inmunohistoquímicos confirma la sospecha de tumor de GIST positivo para cKit/CD117. Se realiza la resección quirúrgica del tumor con dimensiones 4,2x3 cm. Posterior a la cirugía la paciente se encontraba estable y bajo seguimiento clínico hasta ser dada de alta. Los hallazgos clínicos, el diagnóstico y el tratamiento oportuno contribuyen a aumentar la supervivencia ante las complicaciones.

DOI

https://doi.org/10.25176/RFMH.v23i1.5309

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