A Case of Huge Gastrointestinal Stromal Tumor and Thecoma with Massive Bloody Ascites

An 82-year-old woman who was pointed out an abnormal shadow of the stomach by upper gastrointestinal series at a gastric cancer screening was diagnosed to have a submucosal tumor of the stomach and cholecystolithiasis. At surgery, a 11 cm tumor growing extraluminally from the anterior wall of the cardia and a hard right ovarian tumor with massive bloody ascites was observed. Total gastrectomy, cholecystectomy and right oophorectomy were performed. Immunohistochemical study showed that the gastric tumor was negative for myogenic and neurogenic markers, but was positive for CD34 and vimentin. From these observations, the gastric tumor was suspected to be gastrointestinal stromal tumor (GIST) with low malignant potential. The ovarian tumor was diagnosed as thecoma by Sudan stain and silver impregnation method. We suspected that the massive bloody ascites was due to thecoma and rupture of the GIST with bleeding. The postoperative course was uneventful and she had no sign of recurrence for three years.