Upper Gastrointestinal Bleeding as Presentation of Gastric Gastrointestinal Stromal Tumor: Case Report
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Abstract
Background: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms that account for 1–3% of gastric tumors and arise from the interstitial cells of Cajal. Clinical presentation is variable and may include gastrointestinal bleeding, abdominal pain, anemia, or weight loss. Surgical resection remains the standard treatment for localized disease, requiring accurate clinical, endoscopic, radiologic, and histopathologic evaluation for diagnosis and management.
Case Report: Case report of a 69-year-old man with weight loss, anorexia, and melena caused by a gastric gastrointestinal stromal tumor (GIST). Endoscopy revealed an ulcerated submucosal lesion, while contrast-enhanced CT confirmed a gastric mass without metastases. Endoscopic tattooing and laparoscopic partial gastrectomy were performed. Histopathology confirmed a low-risk GIST (CD117+, DOG1+, negative margins). The patient recovered without complications, was discharged on postoperative day four, and remained recurrence-free at 6 months. This case highlights the importance of multidisciplinary management, imaging-guided laparoscopic surgery, and immunohistochemistry for accurate diagnosis and low-morbidity treatment of gastric GIST presenting as upper gastrointestinal bleeding.
Conclusion: Gastrointestinal stromal tumors (GISTs) should be considered in the differential diagnosis of upper gastrointestinal bleeding associated with gastric subepithelial lesions. A multidisciplinary approach, contrast-enhanced computed tomography, endoscopic marking, and laparoscopic resection enable safe and effective treatment of localized low-risk tumors.
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