J Korean Surg Soc.  2011 Jun;80(Suppl 1):S12-S16. 10.4174/jkss.2011.80.Suppl1.S12.

Segmental duodenectomy with duodenojejunostomy of gastrointestinal stromal tumor involving the duodenum

• Chung JC
• Kim HC
• Chu CW

• KMID: 2096642
• DOI: http://doi.org/10.4174/jkss.2011.80.Suppl1.S12

Abstract

Duodenal gastrointestinal stromal tumors (GISTs) are uncommon and a relatively small subset of GISTs whose optimal surgical procedure has not been well defined. Because submucosal spread and local lymph node involvement is infrequent in GISTs, wide margins with routine lymph node dissection may not be required. Various techniques of limited resection for duodenal GISTs have been described depending on the site and the size of the tumors. In this study, we report two cases of GIST involving the third and fourth portion of the duodenum successfully treated by segmental duodenectomy with end-to-end duodenojejunostomy. This technique should be considered as a treatment option for GIST located at the third and fourth portion of the duodenum.

Keyword

Gastrointestinal stromal tumor; Duodenum; Surgery

MeSH Terms

Duodenum
Gastrointestinal Stromal Tumors
Lymph Node Excision
Lymph Nodes

Figure

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  Fig. 1 Computed tomography showed a well-demarcated enhancing tumor 4.0 cm in diameter in the third portion of the duodenum (arrow).

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  Fig. 2 (A) An exophytic GIST of the third portion of the duodenum. (B) Segmental duodenectomy with end-to-end duodenojejunostomy.

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  Fig. 3 (A) Microscopic appearance of the duodenal gastrointestinal stromal tumor showing spindle cells (H&E, ×200). (B) The tumor cells react positively for CD 117 (×100).

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  Fig. 4 Computed Tomography scan showed a well-demarcated enhancing tumor with 4.5 cm in diameter in the fourth portion of the duodenum (arrow).

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