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Case Report

A Case of Gastrointestinal Stromal Tumor of the Rectum Presenting as Constipation

Shin A Lee, Ki Nam Shim, Sun Hee Roh, Min Jin Lee, Hye In Kim, Seung Jung Jun, Da Yeon Oh, Sung Chul Hong, Jae In Ryu, Kwang-Ho Kim1
The Ewha Medical Journal 2011;34(2):47-50. Published online: September 30, 2011

Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.

1Department of Surgery, Ewha Womans University School of Medicine, Seoul, Korea.

Corresponding author (shimkn@ewha.ac.kr)

Copyright © 2011. Ewha Womans University School of Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • A gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor of the gastrointestinal tract and expresses CD117, a c-kit proto-oncogene, which can be detected immunohistochemically. We reported a GIST of the rectum of a 61-year-old-woman who had visited emergency room complaining of constipation over one week. Upon rectal examination, a round hard mass was palpated. Colonoscopy showed a 7×5 cm sized protruded lesion with surface ulceration on a rectum, adjacent the anus. And abdomen computed tomography revealed the soft tissue mass compressing anterolateral wall of the rectum and these findings suggest possibility of rectal submucosal tumor such as GIST. The patient had been treated with a ultra anorectal anastomosis with loop ileostomy. Immunohistochemical studies on the surgically resected specimen showed c-kit (+) and CD34 (+). The final diagnosis was a GIST of the rectum. She was grouped into high risk and she has been given adjuvant chemotherapy with Imatinib.
  • Keywords: Gastrointestinal stromal tumor; Rectum; Constipation
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Fig. 1
Colonoscopic findings. There is a 7×5 cm sized protruded lesion with surface ulceration in the rectum, adjacent to the anus.
emj-34-47-g001.jpg
Fig. 2
Abdomen CT findings. Abdominal CT shows the soft tissue mass (arrows) compressing anterolateral wall of the rectum and these findings suggest possibility of rectal submucosal tumor such as GIST.
emj-34-47-g002.jpg
Fig. 3
Pathologic findings. (A) It shows hypercellular spindle cells with high mitotic count (9/50 HPF) (H&E, ×400). (B) It shows positive expression on immunochemical stain for c-kit (c-kit, ×400).
emj-34-47-g003.jpg

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      A Case of Gastrointestinal Stromal Tumor of the Rectum Presenting as Constipation
      Ewha Med J. 2011;34(2):47-50.   Published online September 30, 2011
      DOI: https://doi.org/10.12771/emj.2011.34.2.47
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      A Case of Gastrointestinal Stromal Tumor of the Rectum Presenting as Constipation
      Ewha Med J. 2011;34(2):47-50.   Published online September 30, 2011
      DOI: https://doi.org/10.12771/emj.2011.34.2.47
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      A Case of Gastrointestinal Stromal Tumor of the Rectum Presenting as Constipation
      Image Image Image
      Fig. 1 Colonoscopic findings. There is a 7×5 cm sized protruded lesion with surface ulceration in the rectum, adjacent to the anus.
      Fig. 2 Abdomen CT findings. Abdominal CT shows the soft tissue mass (arrows) compressing anterolateral wall of the rectum and these findings suggest possibility of rectal submucosal tumor such as GIST.
      Fig. 3 Pathologic findings. (A) It shows hypercellular spindle cells with high mitotic count (9/50 HPF) (H&E, ×400). (B) It shows positive expression on immunochemical stain for c-kit (c-kit, ×400).

      Fig. 1

      Fig. 2

      Fig. 3

      A Case of Gastrointestinal Stromal Tumor of the Rectum Presenting as Constipation
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