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Open Access Highly Accessed Case report

A large gastrointestinal stromal tumor of the duodenum treated by partial duodenectomy with Roux-en-Y duodenojejunostomy: a case report

Ouadii Mouaqit1*, Leila Chbani2, Khalid Maazaz1, Afaf Amarti2, Khalid Ait Taleb1 and Abdelmalek Oussaden1

Author Affiliations

1 Surgery Department, University Hospital Hassan II, Fez, Morocco

2 Department of Pathology, University Hospital Hassan II, Fez, Morocco

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Journal of Medical Case Reports 2013, 7:184  doi:10.1186/1752-1947-7-184

Published: 15 July 2013

Abstract

Introduction

Duodenal gastrointestinal stromal tumors are uncommon and a relatively small subset of gastrointestinal stromal tumors whose optimal surgical procedure has not been well defined. Because submucosal spread and local lymph node involvement are infrequent in gastrointestinal stromal tumors, wide margins with routine lymph node dissection may not be required. Various surgical procedures for duodenal gastrointestinal stromal tumor, pancreatoduodenectomy, pancreas-sparing duodenectomy, segmental duodenectomy, or local resection, have been described depending on the size and exact site of the lesion.

Case presentation

We present the case of a 65-year-old African woman with a giant gastrointestinal stromal tumor involving the second and third portion of the duodenum successfully treated by partial duodenectomy with duodenojejunostomy. This surgical technique is ideal when a gastrointestinal stromal tumor does not involve the ampulla because it avoids a pancreatoduodenectomy, and has not been previously described for the management of this malignancy. Duodenal gastrointestinal stromal tumor should be suspected in any patient with a duodenal wall mass.

Conclusions

Gastrointestinal stromal tumors of the duodenum should be suspected in any patient with a duodenal wall mass. Extramural growth and central ulceration with or without bleeding should alert the endoscopist to the possibility of a duodenal gastrointestinal stromal tumor diagnosis.

Keywords:
Duodenojejunostomy; Duodenum; Gastrointestinal stromal tumors; Surgery