# Gastrointestinal stromal tumor of the small intestine presenting as a giant intratumoral abscess: a rare case report

## TL;DR

A rare case of a gastrointestinal stromal tumor in the small intestine presented as a large abscess and was successfully treated with surgery and medication.

## Contribution

This case report highlights the rare presentation of GIST as a giant intratumoral abscess and emphasizes its inclusion in differential diagnoses.

## Key findings

- A 48-year-old female presented with a large cystic mass in the small intestine with abscess-like features.
- The patient was successfully treated with laparoscopic surgery and a 14-day antibiotic course.
- Follow-up treatment with imatinib was initiated after surgery.

## Abstract

Gastrointestinal stromal tumors (GIST) are rare, but they are the most common mesenchymal tumors of the gastrointestinal tract. Here, we present a case of 48 years medically free female presenting with progressive abdominal distension associated with abdominal discomfort for 2 months. On physical examination, she was hemodynamically stable with a hugely distended abdomen but soft and lax. Laboratory findings revealed leukocytosis and 16 other labs were unremarkable. Computed tomography (CT) of the abdomen showed a large cystic mass likely arising from small bowel loops measuring 30 × 19 × 22 cm. The lesion has a peripheral soft tissue component measuring 3 cm in thickness enhanced with contrast material, suggesting hypervascularity. A large air-fluid level with a large volume of intra-cystic fluids was present, which is concerning for associated enteric fistula. No bowel obstruction was observed. The plan was to start the patient on antibiotics and to proceed with diagnostic laparoscopy for cyst excision with possible resection and anastomosis of the small bowel. Furthermore, she was discharged on day 5 with an uneventful postoperative course as the patient was started on IV antibiotics postoperatively and was discharged on oral antibiotics to complete 14 days. 6-month follow-up patient started on imatinib. Although GISTs presenting as predominantly cystic lesions are very rare, they should be considered one of the differential diagnoses of such a presentation.