A case of small bowel GIST mimicking an ovarian mass

Abstract

55 year old female came with complaints of  abdominal pain and vomiting for 2 weeks. On examination she had a firm mass in the hypogastric region which was not mobile. Imaging studies suggested an adnexal mass and a diagnosis of ovarian mass was made provisionally. on           laparotomy, a mass was found adherent to the uterus and bladder and connected to the ileal mesentery via a stalk. en bloc excision of the mass along with resection of the involved bowel segment done followed by anastamosis of the bowel ends. HPE report came as low grade GIST. she was put on Imatinib. The Gastrointestinal stromal tumours are the most common mesenchymal tumours of gastrointestinal tract.  Majority are associated with mutations in the c-KIT gene. They grow as endophytic masses or exophytic excrescences. The most common site is the stomach followed by the small bowel. Most are asymptomatic. The rest present with vague symptoms or features due to complications like obstruction or perforation. Diagnosis is established by imaging and    immunohistochemistry. The most important prognostic factors include the size, the site and mitotic count. Surgical excision is the main mode of treatment and it offers the only mode of cure. Adjuvant therapy is by using tyrosine kinase inhibitors. 5 year survival rate varies from 28-60 percent. Long term yearly follow up is necessary to detect recurrences.