Publication:

An unusual presentation of a retroperitoneal gastrointestinal stromal tumors

Gastrointestinal stromal tumors (GIST) are soft tissue mesenchymal tumor originating from intestinal cells of Cajal which are pace makers of the intestine. GIST commonly arises from stomach and intestine although they seem to appear occasionally in mesentery, omentum and esophagus, but origin from retro-peritoneum is very infrequent.  We herein report case of a huge retroperitoneal GIST measuring 16x13x9 cm size, in a 52-year-old lady occupying whole abdomen arising as pelvic mass. GIST was initially mistaken with associated large intramural fibroid uterus and a large pedunculated sub-serosa broad ligament fibroid. Patient was taken for abdominal open hysterectomy with complete tumor excision after all adhesions from adjoining intestine was separated. Histopathological examination of the mass confirmed it was retroperitoneal GIST with positive immune-histochemistry. Patient responded well to Imatinib therapy, and for last 4 years there has been no residual disease or recurrence as evidenced with regular follow up.