From Black Stools to Gastrointestinal Stromal Tumor (GIST): A Case Report and Literature Review on This Unsuspected Danger

TL;DR

A 42-year-old woman with no prior health issues was diagnosed with a high-grade gastrointestinal stromal tumor (GIST) after presenting with black stools and upper gastrointestinal bleeding.

Contribution

This case emphasizes the importance of considering GIST in middle-aged individuals with unexplained upper gastrointestinal bleeding and no typical risk factors.

Findings

A high-grade GIST was identified in a patient with no prior medical history or typical risk factors for gastrointestinal bleeding.

Early detection and surgical intervention are critical for improving patient outcomes in such cases.

Adjuvant imatinib therapy is recommended for high-risk GIST patients to reduce recurrence risk.

Abstract

This case report presents the clinical details of a 42-year-old female without previous medical issues who presented with upper gastrointestinal bleeding (UGIB) characterized by melanotic stools. Initial examination revealed mild anemia and subsequent endoscopy identified a 4 cm submucosal gastric mass displaying recent bleeding indicators. Subsequent surgical pathology confirmed a high-grade gastrointestinal stromal tumor (GIST) of grade 2 with a heightened risk of recurrence. The significance of this case lies in underscoring the necessity of considering GIST in the differential diagnosis of UGIB, particularly among middle-aged individuals with no identifiable risk factors such as recent or chronic non-steroidal anti-inflammatory drug (NSAID) use, peptic ulcer disease, or alarm symptoms. Early detection and prompt surgical intervention assume paramount importance in enhancing patient outcomes. While complete resection stands as the cornerstone of treatment, adjuvant imatinib therapy is recommended for high-risk patients to mitigate the risk of recurrence.

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