Published online Nov 06, 2009.
https://doi.org/10.4174/jkss.2009.77.5.357
Primary Retroperitoneal Malignant Gastrointestinal Stromal Tumor Mimicking Adrenal Mass
Abstract
Gastrointestinal stromal tumor (GIST) is the most common non-epithelial tumor in the gastrointestinal tract. Although GIST occurs mainly in the gastrointestinal tract, it also occurs, rarely, in non-gastrointestinal tract and in this case, it is often named as extra-gastrointestinal stromal tumor (EGIST). We experienced a 68-year-old male patient who had been diagnosed preoperatively with accidentaloma of the left adrenal gland by computed tomography, and finally diagnosed as primary retroperitoneal malignant GIST, postoperatively. The operation was performed via anterior abdominal approach, and complete surgical resection was done for a 7 cm sized retroperitoneal tumor near the left adrenal gland. Primary retroperitoneal malignant GIST was the final pathologic diagnosis and the size of the tumor was 6.5 cm and the mitotic count was 7 per high-power field. Diffuse strong positive staining for c-kit protein, CD34 and negative staining for desmin were observed in a immunohistochemistry test. We report here the unusual case of primary retroperitoneal malignant GIST mimicking adrenal mass.
Fig. 1
(A) Well-marginated and well enhancing mass with central necrosis is found (arrow) near lateral limb of left adrenal gland (arrow head) and size of tumor is about 6.2×4.6 cm in preoperative computerized tomography. (B) Tumor is no longer found and normal appearance of lateral limb of left adrenal gland is found (arrow head) in postoperative computerized tomography.
Fig. 2
Well-developed membranous capsular tissue is shown in gross specimen of primary retroperitoneal malignant gastrointestinal tumor (A) and solid tumor with gray-white flesh tissue content is shown at cut surface (B).
Fig. 3
(A) Microscopic findings of primary retroperitoneal malignant gastrointestinal tumor (H&E staining, ×100). (B) Mitosis is observed in center of field (circle) (H&E staining, ×400). Diffuse strong positive staining for c-kit protein (C) and CD34 (D) is observed in immunohistochemistry test (×100).
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