J Korean Surg Soc.  2009 Nov;77(5):357-361. 10.4174/jkss.2009.77.5.357.

Primary Retroperitoneal Malignant Gastrointestinal Stromal Tumor Mimicking Adrenal Mass

• Hwang KT
• Chung JK
• Jung IM
• Heo SC
• Ahn YJ
• Ahn HS
• Chang MS

• KMID: 1750706
• DOI: http://doi.org/10.4174/jkss.2009.77.5.357

Abstract

Gastrointestinal stromal tumor (GIST) is the most common non-epithelial tumor in the gastrointestinal tract. Although GIST occurs mainly in the gastrointestinal tract, it also occurs, rarely, in non-gastrointestinal tract and in this case, it is often named as extra-gastrointestinal stromal tumor (EGIST). We experienced a 68-year-old male patient who had been diagnosed preoperatively with accidentaloma of the left adrenal gland by computed tomography, and finally diagnosed as primary retroperitoneal malignant GIST, postoperatively. The operation was performed via anterior abdominal approach, and complete surgical resection was done for a 7 cm sized retroperitoneal tumor near the left adrenal gland. Primary retroperitoneal malignant GIST was the final pathologic diagnosis and the size of the tumor was 6.5 cm and the mitotic count was 7 per high-power field. Diffuse strong positive staining for c-kit protein, CD34 and negative staining for desmin were observed in a immunohistochemistry test. We report here the unusual case of primary retroperitoneal malignant GIST mimicking adrenal mass.

Keyword

Extra-gastrointestinal stromal tumor; Gastrointestinal stromal tumor; Adrenal mass; Retroperitoneal tumor

MeSH Terms

Adrenal Glands
Aged
Desmin
Gastrointestinal Stromal Tumors
Gastrointestinal Tract
Humans
Immunohistochemistry
Male
Negative Staining
Polyenes
Proto-Oncogene Proteins c-kit
Desmin
Polyenes
Proto-Oncogene Proteins c-kit

Figure

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  Fig. 1 (A) Well-marginated and well enhancing mass with central necrosis is found (arrow) near lateral limb of left adrenal gland (arrow head) and size of tumor is about 6.2×4.6 cm in preoperative computerized tomography. (B) Tumor is no longer found and normal appearance of lateral limb of left adrenal gland is found (arrow head) in postoperative computerized tomography.

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  Fig. 2 Well-developed membranous capsular tissue is shown in gross specimen of primary retroperitoneal malignant gastrointestinal tumor (A) and solid tumor with gray-white flesh tissue content is shown at cut surface (B).

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  Fig. 3 (A) Microscopic findings of primary retroperitoneal malignant gastrointestinal tumor (H&E staining, ×100). (B) Mitosis is observed in center of field (circle) (H&E staining, ×400). Diffuse strong positive staining for c-kit protein (C) and CD34 (D) is observed in immunohistochemistry test (×100).

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