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Cirujano general
Print version ISSN 1405-0099
Abstract
VARGAS-AVILA, Arcenio Luis et al. GIST in second portion of duodenum, surgical approach, case report and literature review. Cir. gen [online]. 2019, vol.41, n.3, pp.191-201. Epub Nov 27, 2020. ISSN 1405-0099.
Gastrointestinal stromal tumors (GIST) are the most common mesenchymal neoplasms, although annual reported incidence rates worldwide are less than 20 per million. These tumors are a primary gastrointestinal disease that can arise anywhere in the digestive tract in adults. Duodenal lesions represent approximately 3 to 5%, although duodenal gastrointestinal stromal tumors are relatively rare, they account for almost 30% of all primary tumors of the duodenum, they originate most frequently in the second portion of the duodenum, followed in order by the third, fourth and first portion. We present the case of a 54-year-old patient with a history of neurofibromatosis, which occurred with episodes of bleeding of three years of evolution, with diagnosis of duodenal polyp; the histopathological study reported gastrointestinal stromal tumor, with an immunohistochemical study that was positive for CD117, CD34 and DOGL, with an account of less than 2 mitosis / 50 CAP. Surgical management was decided, a 3-cm tumor was identified in the lateral wall of the duodenum. In the second portion, wedge resection and primary closure were performed in two suture lines. Local resection is appropriate when feasible and pancreaticoduodenectomy should be reserved for lesions that are not amenable to local resection.
Keywords : Gastrointestinal stromal tumor; surgery; pancreaticoduode-nectomy; resection margins.