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• W2977619703 abstract "Introduction: The patient is a 71-year-old woman with a past medical history of melenoma, who presented to the hospital with progressively worsening intermittent dysphagia, mainly for solid foods over the past year. Associated symptoms included reflux without significant weight loss. She typically had to chase solid food down with liquids in order to prevent any type of impaction. She has never had any food impaction that has required a food bolus removal. EGD 6 months prior was unremarkable. Endoscopy revealed a large 4-5-cm subepithelial lesion in the mid-esophagus at around 30 cm. The lesion appeared smooth with normal overlying smooth tissue. There were no obvious ulcerations. Biopsies were not taken at that time. CT scan of the chest confirmed the presence of a large submucosal mass in the distal esophagus. Repeat biopsy was performed with EUS and biopsy. No extra-esophageal masses were identified, and biopsy was proven for gastrointestinal stromal tumor. The patient was started on neoadjuvant chemotherapy with Gleevec®, with future plans for surgical resection. Discussion: Gist tumors’ presentation is generally vague, and varies depending on which part of the GI tract is affected. As they are a mass-occupying lesion, they may present as an obstruction.In the esophagus, it may present as dysphagia; it may even mimic symptoms of GERD. In this case, when the tumor was in the esophagus, it presented as dysphagia. When it plunged into the stomach, patient was asymptomatic. When EGD was first performed 6 month prior to diagnosis, the mass was missed, as it was most likely plunged into the stomach. Gist tumors may often present simply as abdominal discomfort with weight loss, as 75% of these tumors arise from the stomach. Some of the GIST tumors are found incidentally, and in about 2/3 of the cases, the size of the tumor is less than 4 cm at diagnosis. As it is evident that GIST has a wide array of symptoms, the differential is vast and modalities for diagnosis would be dependent on which part of the gut is affected. Generally, these tumors may be visualized on imaging such as barium swallow, CT, MRI, and may also be visualized and biopsied via EGD in the upper GI, or colonoscopy in the lower GI tract. Treatment for GIST is surgical resection when possible. Pharmaceutical therapies such as imatinib, Sunitib, and regorafebib all acting as a tyrosince kinase receptor blocker.Figure 1: Endoscopic visualization of tumor in the esophagus (left), tumor plunged into the stomach (right)." @default.
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• W2977619703 date "2014-10-01" @default.
• W2977619703 modified "2023-09-27" @default.
• W2977619703 title "A Case of Plunging GIST Presenting as Intermittent Dysphagia" @default.
• W2977619703 doi "https://doi.org/10.14309/00000434-201410002-00769" @default.
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