Gastric stromal tumor presented as hemorrhagic ascites

Abstract

Gastric stromal tumor is a rare neoplasm, which mainly affects 50 to 70 year-old patients of both genders. Clinical manifestations commonly found are anemia, gastrointestinal hemorrhage, abdominal pain and palpable mass. We report a case of a 38-year-old male patient presenting abdominal pain, especially in epigastrium, associated to anemia, weight loss and intestinal constipation for two months. Upon examination, the patient appeared to be in good conditions, pale skinned, painful globous abdomen, presenting signs of ascites. Gastric endoscopy revealed a sessile polypoid fragment with central ulceration in greater curvature. A biopsy of the polyp revealed no malignancy and a computerized tomography (CT) scan of the abdomen demonstrated a large meso to hypogastric mass, measuring 20 x 13cm in large diameters, associated to the presence of ascites. The patient underwent a laparotomy, which showed hemorrhagic ascites and a big cystic tumor in the gastric greater curvature. An extended partial gastrectomy was proceeded. The pathologic diagnosis was a malignant stromal gastric tumor. The patient is now asymptomatic and free of the sickness after 24 months.