A team of researchers from Greece reported a very rare case of liver gastrointestinal stromal tumor (GIST) in an article published in the Journal of Surgical Case Reports. 

GISTs are the most common mesenchymal abnormal cell growths of the gastrointestinal tract. In 40% to 70% of cases, they are found in the stomach. They can also sometimes occur in the small intestine, rectum, and, in rare cases, the esophagus. 

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Very few cases of GIST affecting the liver have been reported in the literature so far. The one reported in the present study is that of a man of Caucasian descent, aged 37 years, who was admitted to the Division of Transplant Surgery of Aristotle University of Thessaloniki in Ippokratio General Hospital, Greece.

The patient had a 2-month history of mild abdominal pain, early satiety, and gas. Following a physical examination where a palpable mass was felt, he underwent a computed tomography scan. This revealed a big mass in his left hepatic lobe, which was made of spindle and epithelial cells. 

The tumor was removed and the tissue was analyzed with immunohistochemistry, which showed it strongly expressed CD117, a transmembrane tyrosine kinase receptor coded by the KIT proto-oncogene, suggesting it was a GIST.

“In our case, the radiological findings were primarily suggestive of a cystadenocarcinoma, thus the immunohistochemical findings played a vital role in establishing the correct diagnosis,” wrote first author Athanasios Piachas, MD, PhD, and coauthors of the study. 

The underscored the importance of a full preoperative examination, which should include a radiological examination as well as an upper and lower endoscopy, so that the correct diagnosis can be reached and the patient can be offered the right treatment. 

The patient recovered well and was discharged from the hospital on day 7 after the operation.

Reference

Piachas A, Tooulias A, Tsoulfas G. Primary gastrointestinal stromal tumor of the left hepatic lobe: a case report and a review of the literature. J Surg Case Rep. 2021;12:rjab572. doi:10.1093/jscr/rjab572