Anorectal Gastrointestinal Stromal Tumor: A Case Report and Literature Review

Author:

Singhal Sanjeev1,Singhal Anu2,Tugnait Rahul1,Varghese Vineet1,Tiwari Bishwanath1,Arora Pankaj K.1,Malik Pawan1,Bharali Mriganka Deuri1,Dhuria Ankur Subhash1,Chauhan Pushkar1,Singh Chandrakant1,Ballani Amit3,Panwar Vishnu4

Affiliation:

1. Department of Surgery, Northern Railway Central Hospital, New Delhi, India

2. Department of Radiology, ESI Model Hospital and PGIMSR, Basaidarapur, New Delhi 110001, India

3. Department of Radiology, Northern Railway Central Hospital, New Delhi, India

4. Department of Anaesthesia, Northern Railway Central Hospital, New Delhi, India

Abstract

Gastrointestinal stromal tumors or “GIST” are mesenchymal neoplasms expressing KIT(CD117) tyrosine kinase and showing the presence of activating mutations in KIT orPDGFRα(platelet-derived growth factor alpha). GIST of anal canal is an extremely rare tumor, accounting for only 3% of all anorectal mesenchymal tumors and 0.1–0.4% of all GIST. GIST with large tumor size and high mitotic activity are highly malignant, but the biological behavior of anorectal GIST is less clear. Abdominoperineal resection (APR) or conservative surgery is the best treatment option. Imatinib mesylate, a tyrosine kinase inhibitor, has shown promising results in its management. We present a case of anorectal GIST diagnosed by computed tomography (CT) scan, magnetic resonance imaging (MRI), and colonoscopy with biopsy. The patient underwent abdominoperineal resection (APR) and was confirmed on histopathology to have anal canal GIST with tumor size more than 5 cm in maximum dimension and mitotic figures more than 5/50 high power field (HPF). The CD117—immunoreactive score—was 3+ in spindled cells. Therefore the patient was put on adjuvant imatinib mesylate 400 mg daily.

Publisher

Hindawi Limited

Subject

General Engineering

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