A Fistulized Giant Duodenal Stromal Tumor in a Young Patient: A Case Report With Literature Review for Tomographic Diagnosis

Abstract

Background: Duodenal gastrointestinal stromal tumors (GISTs) are rare tumors of the gastrointestinal tract. It should be considered in the differential diagnosis of periampullary region pathologies. Case Report: A 24-year-old male patient applied to the general surgery department with the complaint of long-standing abdominal pain, nausea and vomiting after meals, and 8-10 kg weight loss in 1 month. Three-phase dynamic abdominopelvic CT showed that the 1st and the 2nd segments of the duodenum were dilated. At this level, a peripherally intensely contrasted heterogeneous mass lesion, 91x70x46 mm in size, was observed. There was oral contrast and air values in the center of the mass. A fistulized mass connected with the duodenal wall was considered in the differential diagnosis. In the surgical exploration, a soft, vascularized mass fistulized to the 2nd segment of the duodenum was observed. Pathological diagnosis was reported as GIST. Conclusion: GISTs arise from the precursors of Cajal Interstitial cells of the gastrointestinal tract. Contrast-enhanced CT is the preferred diagnostic method for staging, risk stratification, and follow-up. We presented a young case with a giant duodenal GIST and discussed differential diagnosis and some diagnostic properties.