Annals of Coloproctology

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Abdominosacral Resection in the Management of Large-Size Retrorectal Tumors: A Report of 2 Rare Cases: Yuda Handaya, Sutamto Wibowo; Ann Coloproctol. 2018;34(5):271-276. Published online October 10, 2018; DOI: https://doi.org/10.3393/ac.2017.12.01

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Abstract PDF: Management of large-size retrorectal gastrointestinal stromal tumors (GISTs) is complex and challenging from diagnosis to treatment. This may create technical difficulties in surgical access and complete resection of the tumor. The abdominosacral resection has the benefit of improved visualization via the anterior incision, with enhanced exposure of the midrectal area, which makes resecting the tumor completely via the posterior approach easier. We report 2 cases of patients with a retrorectal GIST and neurofibromatosis type 1, one in a 27-year-old woman with a defecation complaint and the other in a 58-year-old woman with a defecation and urination complaint. Based on the anatomical pathology, both patients were diagnosed with a GIST. The tumors were excised via an abdominosacral resection. Retrorectal GISTs are rare, and abdominosacral resection allows complete resection of a large-size retrorectal GIST with low morbidity and an absence of functional impairment. The abdominosacral resection should be considered in certain situations.

An Extragastrointestinal Stromal Tumor in the Omentum With Peritoneal Seeding Mimicking an Appendiceal Mucinous Cancer With Carcinomatosis: Jeonghyun Kang, Tae Joo Jeon, Sun Och Yoon, Kang Young Lee, Seung-Kook Sohn; Ann Coloproctol. 2014;30(2):93-96. Published online April 25, 2014; DOI: https://doi.org/10.3393/ac.2014.30.2.93

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6 Citations

Abstract PDF

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. These tumors tend to present most frequently in the stomach, followed by the small intestine. GISTs can also arise from the omentum, retroperitoneum, mesentery, or pleura and are termed extragastrointestinal stromal tumors (EGISTs) when they do so. EGISTs arising from the omentum are very rare. Due to the limited incidence of EGISTs in the omentum, the diagnostic criteria are not well established, and making a correct diagnosis may be difficult. In this report, we present a case of an EGIST of the omentum with peritoneal metastasis that was initially suspected to be an appendiceal mucinous carcinoma with carcinomatosis on positron emission tomography/computed tomography imaging.

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An update on gastrointestinal stromal tumors (GISTs) with a focus on extragastrointestinal stromal tumors (EGISTs)
Fatima Usama, Rohullah Rasikh, Khawaja Hassam, Mansoor Rahman, FNU Khalil Ur Rehman, Iman Waheed Khan, Daryl T -Y Lau
Gastroenterology Report.2025;[Epub] CrossRef
Primary Extragastrointestinal Stromal Tumor of Greater Omentum with Intraperitoneal Bleeding
Masatoshi Kataoka, Tsukasa Saitoh, Kousaku Kawashima, Tomotaka Yazaki, Hiroki Sonoyama, Eiko Okimoto, Akihiko Oka, Yoshiyuki Mishima, Tsuyoshi Mishiro, Naoki Oshima, Kotaro Shibagaki, Hiroshi Tobita, Ichiro Moriyama, Norihisa Ishimura, Mamiko Nagase, Nori
Internal Medicine.2021; 60(21): 3413. CrossRef
Recurrent and metastatic extragastrointestinal stromal tumors of the mesentery with C-KIT and PDGFRA mutations: a case report
Huang Yayu, Zhang Changmao, Dai Yijun, Lin Na, Xu Tianwen, Dai Yangbin
Cancer Biology & Therapy.2020; 21(2): 101. CrossRef
Mucinous Carcinomatosis: A Rare Association between an Ovarian Tumor and an E-GIST
Hugo Palma Rios, André Goulart, Pedro Leão
Case Reports in Surgery.2018; 2018: 1. CrossRef
Extra-gastrointestinal stromal tumour. Report of primary tumour in the omentum
E.N. Valdes-Peregrina, M. Hernández-González, O. de León-Pacheco, S. Mendoza-Ramírez
Revista Médica del Hospital General de México.2018; 81(4): 221. CrossRef
Clinicopathological features and prognosis of omental gastrointestinal stromal tumor: evaluation of a pooled case series
Fan Feng, Yangzi Tian, Zhen Liu, Shushang Liu, Guanghui Xu, Man Guo, Xiao Lian, Daiming Fan, Hongwei Zhang
Scientific Reports.2016;[Epub] CrossRef

Efficacy of Imatinib Mesylate Neoadjuvant Treatment for a Locally Advanced Rectal Gastrointestinal Stromal Tumor: Kyu Jong Yoon, Nam Kyu Kim, Kang Young Lee, Byung Soh Min, Hyuk Hur, Jeonghyun Kang, Sarah Lee; J Korean Soc Coloproctol. 2011;27(3):147-152. Published online June 30, 2011; DOI: https://doi.org/10.3393/jksc.2011.27.3.147

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10 Citations

Abstract PDF

Surgery is the standard treatment for a primary gastrointestinal stromal tumor (GIST); however, surgical resection is often not curative, particularly for large GISTs. In the past decade, with imatinib mesylate (IM), management strategies for GISTs have evolved significantly, and now IM is the standard care for patients with locally advanced, recurrent or metastatic GISTs. Adjuvant therapy with imatinib was recently approved for use, and preoperative imatinib is an emerging treatment option for patients who require cytoreductive therapy. IM neoadjuvant therapy for primary GISTs has been reported, but there is no consensus on the dose of the drug, the duration of treatment and the optimal time of surgery. These are critical because drug resistance or tumor progression can develop with a prolonged treatment. This report describes two cases of large rectal malignant GISTs, for which a abdominoperineal resection was initially anticipated. The two patients received IM preoperative treatment; we followed-up with CT or magnetic resonance imaging to access the response. After 9 months of treatment, a multi-disciplinary consensus that maximal benefit from imatinib had been achieved was reached. We determined the best time for surgical intervention and successfully performed sphincter-preserving surgery before resistance to imatinib or tumor progression occurred. We believe that a multidisciplinary team approach, considerating the optimal duration of therapy and the timing of surgery, is required to optimize treatment outcome.

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Safety, effectiveness and the optimal duration of preoperative imatinib in locally advanced gastric gastrointestinal stromal tumors: A retrospective cohort study
Xiangfei Sun, Xiaohan Lin, Qiang Zhang, Chao Li, Ping Shu, Xiaodong Gao, Kuntang Shen
Cancer Medicine.2024;[Epub] CrossRef
Clinicopathological and Immunohistochemical Characterization of Gastrointestinal Stromal Tumour at Four Tertiary Health Centers in Nigeria Using CD117, DOG1, and Human Epidermal Growth Factor Receptor-2 Biomarkers
Mumini Wemimo Rasheed, Afolayan Enoch Abiodun, Uchechukwu Brian Eziagu, Najeem Adedamola Idowu, Abdullahi Kabiru, Taiwo Adeyemi Adegboye, Waheed Akanni Oluogun, Adekunle Adebayo Ayoade
Annals of African Medicine.2023; 22(4): 501. CrossRef
Open transanal resection of low rectal stromal tumor following neoadjuvant therapy of imatinib mesylate: Report of 11 cases and review of literature
Qiang Sun, Ning Su, Xinxing Li, Zhiqian Hu, Weijun Wang
Asia-Pacific Journal of Clinical Oncology.2020; 16(3): 123. CrossRef
Using endoscopy to minimize the extent of resection in the management of giant GISTs of the stomach
Hishaam Ismael, Yury Ragoza, Steven Cox
International Journal of Surgery Case Reports.2017; 36: 26. CrossRef
Combined Therapy of Gastrointestinal Stromal Tumors
Piotr Rutkowski, Daphne Hompes
Surgical Oncology Clinics of North America.2016; 25(4): 735. CrossRef
Indications for surgery in advanced/metastatic GIST
Samuel J. Ford, Alessandro Gronchi
European Journal of Cancer.2016; 63: 154. CrossRef
Surgical treatment of gastrointestinal stromal tumour of the rectum in the era of imatinib
M J Wilkinson, J E F Fitzgerald, D C Strauss, A J Hayes, J M Thomas, C Messiou, C Fisher, C Benson, P P Tekkis, I Judson
British Journal of Surgery.2015; 102(8): 965. CrossRef
Intolerance to Imatinib in Gastrointestinal Stromal Tumors: A Case Report and a Review of Literature
Yousra Akasbi, Samia Arifi, Sami Aziz Brahmi, Fatima Zahra El Mrabet, Nawfel Mellas, Fatima Zahra Mernisi, Omar El Mesbahi
Journal of Gastrointestinal Cancer.2014; 45(S1): 71. CrossRef
Primary localized rectal/pararectal gastrointestinal stromal tumors: results of surgical and multimodal therapy from the French Sarcoma group
Thanh-Khoa Huynh, Pierre Meeus, Philippe Cassier, Olivier Bouché, Sophie Lardière-Deguelte, Antoine Adenis, Thierry André, Julien Mancini, Olivier Collard, Michael Montemurro, Emmanuelle Bompas, Maria Rios, Nicolas Isambert, Didier Cupissol, Jean-Yves Bla
BMC Cancer.2014;[Epub] CrossRef
Neoadjuvant Imatinib in Locally Advanced Gastrointestinal Stromal Tumors (GIST): The EORTC STBSG Experience
Piotr Rutkowski, Alessandro Gronchi, Peter Hohenberger, Sylvie Bonvalot, Patrick Schöffski, Sebastian Bauer, Elena Fumagalli, Pawel Nyckowski, Buu-Phuc Nguyen, Jan Martijn Kerst, Marco Fiore, Elzbieta Bylina, Mathias Hoiczyk, Annemieke Cats, Paolo G. Casa
Annals of Surgical Oncology.2013; 20(9): 2937. CrossRef

Original Articles

Clinicopathological Features of Primary Jejunoileal Tumors: Chang Hyun Kim, Bong Hyeon Kye, Jae Im Lee, Soo Hong Kim, Hyung Jin Kim, Won Kyung Kang, Seong Taek Oh; J Korean Soc Coloproctol. 2010;26(5):334-338. Published online October 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.5.334

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6 Citations

Abstract PDF

Purpose

Tumors of the small bowel are rare, accounting for about 3-6% of all gastrointestinal neoplasms, though they cover more than 90% of the intestinal surface. However, diagnosis and treatment are difficult and present an ongoing challenge for both gastrointestinal surgeons and gastroenterologists. The aim of this study was to investigate the clinical features of small bowel tumors.

Methods

Between November 1994 and November 2007, 81 patients underwent treatments for primary tumors in the jejuno-ileal region at the Department of Surgery, Kangnam St. Mary's Hospital, the Catholic University of Korea. A retrospective review of the patients' characteristics and variable tumor factors was performed.

Results

The mean age of the patients was 53.2 years with 48 men and 33 women. The most common symptom was abdominal pain (59.3%), followed by bleeding (22.2%) and an abdominal mass (6.2%). We found that the patients with ileal tumors complained mainly of abdominal pain (72.9%) whereas the patients with jejunal tumors presented with gastrointestinal bleeding (36.4%) (P = 0.048). Seventy-six of the 81 patients (93.8%) had malignant tumors, including 40 (49.4%) gastrointestinal stromal tumors, 26 (32.1%) lymphomas and 5 (6.2%) adenocarcinomas. No postoperative mortalities were observed. The overall 5-year survival rate of the patients with malignant small bowel tumors was 31.8%.

Conclusion

Because the clinical features of a primary tumor of the small bowel are obscure and its diagnosis is difficult, maintaining a high degree of suspicion and recognizing the possibility of a primary small bowel tumor are important.

Citations

Citations to this article as recorded by

Symptoms Contributing to the Diagnosis of Small Bowel Tumors
Kozo Tsuruta, Hidetoshi Takedatsu, Shinichiro Yoshioka, Masahiro Yoshikai, Kensuke Tomiyasu, Masaru Morita, Kotaro Kuwaki, Keiichi Mitsuyama, Takumi Kawaguchi
Digestion.2023; 104(6): 430. CrossRef
Clinicopathologic features, surgical treatments and outcomes of small bowel tumors
Anh Doanh Nguyen, Tu Hoang Le
Vietnam Journal of Endolaparoscopic Surgey.2022;[Epub] CrossRef
Clinicopathological Features of Small Bowel Tumors Diagnosed by Video Capsule Endoscopy and Balloon-Assisted Enteroscopy: A Single Center Experience
Ah Young Yoo, Beom Jae Lee, Won Shik Kim, Seong Min Kim, Seung Han Kim, Moon Kyung Joo, Hyo Jung Kim, Jong-Jae Park
Clinical Endoscopy.2021; 54(1): 85. CrossRef
Small Bowel Adenocarcinoma – Report of Two Cases and Review of Literature
Philip Umman, Vineeth Adiyodi, Chanchal Narayan
Indian Journal of Surgery.2013; 75(2): 123. CrossRef
Les tumeurs malignes primitives de l’intestin grêle : à propos de 11 cas
A. Farouk, A. Diffaa, R. Hafidi, F. Hlili, K. Krati
Journal Africain d'Hépato-Gastroentérologie.2012; 6(4): 284. CrossRef
A Gastrointestinal Stromal Tumor Presenting as an Emergency: a Case Report
Konstantinos Bouliaris, Aikaterini Michopoulou, Konstantinos Spanos, Vassilios Simopoulos, Ioannis Bolanis, Stylianos Germanos
Journal of Gastrointestinal Cancer.2012; 43(S1): 178. CrossRef

Analysis of c-kit Gene Mutation and Prognostic Factors of GISTs in the Small and the Large Bowel.: Park, Jong Kyung , Yun, Sang Seob , Kang, Won Kyung , Cho, Hyeon Min , Kim, Ji Youn , Choi, Seung Hye , Oh, Seong Taek , Oh, Se Jeong , Oh, Seong Lee , Jeon, Hae Myung; J Korean Soc Coloproctol. 2004;20(1):1-7.

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Abstract PDF: PURPOSE
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors which arise anywhere in the tubular GI tract. The prognosis for GISTs that develop in the small and the large bowel is worse than it is for those that develop at other sites. We examined the significance of c-kit mutation as an independent prognostic factor for GISTs.
METHODS
The hospital records of 27 patients with GISTs in the small and the large bowel who were seen from January 1991 to December 2001 at the Department of Surgery, The Catholic University School of Medicine, were reviewed. c-kit mutation was measured by using the PCR and DNA sequencing.
RESULTS
Mutations in exon 11 were found in 5 cases (83.3%), exon 9 in 1 case (16.7%), and no mutations were noted in exon 13 and exon 17. All mutations in exon 11 were found in codon 560-570. c-kit mutation was observed more frequently in high-risk patients, and there was a significant difference between c-kit mutation and the survival rate (P=0.048).
CONCLUSIONS
We think that codon 550~560 in exon 11 of the c-kit gene is a hotspot of mutation, but c-kit mutation is uncertain as an independent prognostic factor for GISTs.

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