Stage IV duodenal GIST requiring emergency pancreaticoduodenectomy - diagnosis difficulties and therapeutic options

Vol. 59 No. 2, 2018


Cecil Sorin Mirea, Mihai Calin Ciorbagiu, Cosmin Vasile Obleaga, Emil Moraru, Stelian Stefanita Mogoanta, Raluca Niculina Ciurea, Maria Camelia Foarfa, Alina Maria Vilcea, Ionica Daniel Vilcea

This paper presents a very rarely encountered case of a 45-year-old female, admitted in our Surgical Clinic for upper digestive bleeding (repeated hematochezia). The upper endoscopy was negative, but the barium meal discovered an apparently extrinsic duodenal (D3) stenosis; abdominal ultrasound diagnosed a left liver mass suggesting a metastatic tumor. The hematochezia relapse, with hemodynamic instability imposed emergency surgery; on laparotomy, a bleeding tumor located on the duodenopancreatic region was discovered, and a pylorus-preserving pancreaticoduodenectomy (Traverso-Longmire) was performed. The histology and immunohistochemistry established the diagnosis of duodenal stromal tumor, CD34 and CD117 positive, with an estimated progression risk of 34%. The postoperative evolution was favorable, the patient being alive, four years after the surgery.

Corresponding author: Mihai Calin Ciorbagiu, MD, PhD; e-mail:

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