Associated Complication of Gastrointestinal Stromal Tumours of the Small Intestine
https://doi.org/10.25207/1608-6228-2019-26-5-135-142
Abstract
Aim. To consider the possibility of the diagnosis of a rare small bowel tumour complicated by small bowel obstruction and small bowel bleeding, as well as the surgical treatment of this pathology using a minimally invasive surgical approach.
Results and discussion. The authors present a clinical case of associated complication of a gastrointestinal stromal tumour (GIST) of the small intestine in a 48-year-old patient. The patient was admitted to a surgical clinic with small bowel obstruction, episodes of intestinal bleeding and anaemia. The diagnosis was determined using CT enterography. In line with the current trends for minimally invasive surgery, minimally invasive laparotomy was performed drawing on the CT mapping of the anterior abdominal wall. The last stage involved in the morphological verification of GIST, which employs a standard procedure of IHC testing, revealed a malignant GIST, spindle cell variant. The verified histotype of a small intestinal tumour provides the opportunity to choose the necessary variant of adjuvant chemotherapy, as well as to improve general and relapse-free survival.
Conclusion. Minimally invasive operations can be performed in the complicated course of GIST due to the biological properties of this pathology (absence of lymphogenic metastasis and infiltrative growth) without decreasing five-year survival rate. The use of CT helps make a topical diagnosis and plan minimally invasive surgical treatment.
About the Authors
Nikolay A. TrifanovRussian Federation
Postgraduate Researcher, Department for Intermediate Surgery with a course in Anesthesiology and Intensive Care
Mitrofanа Sedina str., 4, Krasnodar, 350063; tel.: +7 (961) 581-25-23
Alexander Ya. Korovin
Russian Federation
Dr. Sci. (Med.), Prof., Department for Intermediate Surgery with a course in Anesthesiology and Intensive Care
Mitrofanа Sedina str., 4, Krasnodar, 350063
Alexander N. Manzhos
Russian Federation
Cand. Sci. (Med.), Research Assistant, Department for Advanced Surgery
Mitrofanа Sedina str., 4, Krasnodar, 350063
Alexey V. Barsuk
Russian Federation
Pathologist
1 Maya str., 167, Krasnodar, 350086
References
1. Yurichev I.N., Burdyukov M.S., Nechai A.M., Chistyakova O.V. Gastrointestinal stromal tumors: problems of diagnosis and treatment (review). Eksperimental’naya i Klinicheskaya Gastroenterologiya. 2012; 9: 60–66 (In Russ., English abstract).
2. Prohorov A.V., Gladyshev A.O., Kursakova L.A., Zubovich V.P. Astrointestinal stromal tumor: patogenesis, clinics, diagnostics, treatment. Onkologicheskii Zhurnal. 2011; 5 (2(18)): 22–28 (In Russ., English abstract).
3. Demetri G.D., von Mehren M., Antonescu C.R., DeMatteo R.P., Ganjoo K.N., Maki R.G., Pisters P.W., Raut C.P., Riedel R.F., Schuetze S., Sundar H.M., Trent J.C., Wayne J.D. J. NCCN Task Force report: update on the management of patients with gastrointestinal stromal tumors. Natl. Compr. Canc. Netw. 2010; 8 Suppl 2:S1–41; quiz S42–4. DOI: 10.6004/jnccn.2010.0116
4. Zemlyanoi V.P., Sigua B.V., Singayevskii A.B., Nikiforenko A.V., Burlachenko E.P., Gurzhii D.V., Kotkov P.A. The case of successful treatment of the patient with gastrointestinal stromal tumor, located in the ileum, complicated with reccurent gastrointestinal bleeding, accompanied by the hemorrhage of moderate severity. Vestnik Severo-Zapadnogo Gosudarstvennogo Meditsinskogo Universiteta im. I.I. Mechnikova. 2014; 6(2): 110–112 (In Russ., English abstract).
5. Kornilova A.G., Kogoniya L.M., Mazurin V.S, Mordanov S.V., Oksenyuk O.S. Gastrointestinal stromal tumors: what’s new in therapy? Sibirskii Onkologicheskii Zhurnal. 2015; 2: 81–87 (In Russ., English abstract).
6. Roman L.D., Shostka K.G., Dovgaluk A.Z., Sakharov A.A., Lukyanchuk R.M., Fedotov B.L., Anton V.G., Gradusov A.A. Stromal gastrointestinal tumor of ileum (clinical case). Statsionarozameshchayushchie Tekhnologii: Ambulatornaya Khirurgiya. 2017; 3–4; 68–74 (In Russ., English abstract).
7. Berelavichus S.V., Kriger A.G., Kaldarov A.R., Kalinin D.V. Minimally invasive surgical treatment of gastrointestinal stromal tumor. Khirurgiya. Zhurnal im. N.I. Pirogova. 2015; 3: 38–41 (In Russ., English abstract). DOI: 10.17116/hirurgia2015338-41
8. Kashchenko V.A., Karachun A.M., Orlova R.V., Pelipas’ Yu. V., Petrova V.V., Nepomnyashchaya S.L., Gluzman M.I., Beskrovnyi E.G. Pecularities of surgical approach in treatment of gastrointestinal stromal tumors. Vestnik Khirurgii im. I.I. Grekova. 2017; 176(2): 22–27 (In Russ., English abstract).
Review
For citations:
Trifanov N.A., Korovin A.Ya., Manzhos A.N., Barsuk A.V. Associated Complication of Gastrointestinal Stromal Tumours of the Small Intestine. Kuban Scientific Medical Bulletin. 2019;26(5):135-142. (In Russ.) https://doi.org/10.25207/1608-6228-2019-26-5-135-142