Researchers from Ethiopia presented the rare case of a patient with a large gastric gastrointestinal stromal tumor (GIST) with a fast-growing mass after intratumoral bleeding. 

“Only a few instances of giant gastrointestinal stromal tumors and even fewer cases of such tumors with intratumoral bleeding have ever been reported,” the researchers wrote in a report published in the Journal of Surgical Case Reports

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The case is that of a 42-year-old male who presented to the hospital with abdominal pain and swelling lasting 5 months. The swelling had been growing fast in the last month. 

The patient was examined physically, which showed a conjunctival pallor and an ill-defined abdominal mass. 

He underwent a contrast-enhanced computed tomography scan, which revealed an intraabdominal mass measuring 32 × 30 × 15 cm with variable enhancements. 

He was treated surgically, and the giant mass weighing 10.5 kg was removed en bloc.

Histopathological examination indicated the proliferation of epithelioid cells with para nuclear clearance and skinoid fibers. There were also areas of necrosis but no mitotic activity. 

He was diagnosed with epithelioid GIST.

The authors concluded that patients presenting with symptoms and signs consistent with anemia developing over a short period and an associated increase in an abdominal mass should be investigated with a contrast-enhanced computed tomography scan. 

In case of a suspicion of GIST with intratumoral bleeding, they should be treated with surgical excision en bloc and adjuvant imatinib treatment based on risk stratification.

GIST is a rare type of soft-tissue tumor that develops from the interstitial cells of Cajal located in the wall of the gastrointestinal tract. Though the tumor can develop anywhere along the gastrointestinal tract, it mostly occurs in the stomach or small intestine. 

The first-line treatment for localized tumors is complete surgical excision avoiding tumor rupture during the procedure.


Duguma YM, Seid TA, Shumiye YG, Dinagde TA, Kejela S. Giant gastric GIST with fast-growing mass after intra-tumoral bleeding. J Surg Case Rep. Published online July 29, 2023. doi:10.1093/jscr/rjad427