AGGRESSIVE BEHAVIOR GASTRIC STROMAL TUMOR – CASE REPORT

Gastrointestinal stromal tumors (GIST) are rare tumors defined by a set of pathological and imunohistological criterias. CASE REPORT: We present herein a 39 years old, woman, admitted in our surgical unit for weight loss and nonspecific digestive symptoms. The physical examrevealed a voluminous mass in the upper abdomen. The CT scan diagnosed a voluminous tumor in the spleen lodge with gastric invasion and a very large tumor in the left liver; another smalltumor was diagnosed in the right inferior pulmonary lobe. The patient was operated and left hepatectomy associated with splenectomy and gastric upper pole resection have been performed.The pathological exam revealed the diagnosis of a malignant gastric stromal tumor, with high risk aggressive behavior and liver metastasis. The pulmonary tumor was also considered as distantmetastasis. The patient was proposed for an imatinib mesylate cure. CONCLUSIONS: GIST are rare tumors; the aggressive malignant pattern is also rare. Surgical resections are indicated when a R0 resection could be performed. The pathological exam can suggest the diagnosis but only CD117 immunostaining is able to differentiate GIST from other mesenchymal tumors. The chemotherapy with tyrosine kinases competitive inhibitors is recommended in aggressive patterns