Transvaginal excision of a large rectal stromal tumor: an alternative

Gastrointestinal stromal tumors (GISTs), the specific kit-positive mesenchymal tumors of the gastrointestinal tract, are rarely found in the anorectum and account for only 0.1% of all colorectal tumors. The main stem of therapy remains surgical excision. The standard surgical approach for anorectal GISTs includes transanal resection or enucleation for smaller and anterior or abdominoperineal resection for larger tumors. We present an alternative, transvaginal approach for a local excision of a large rectal GIST. In our case, a 5 × 5 × 8 cm large GIST located 3 cm above the dentate line in the anterior rectal wall was removed through the vagina. In our experience, this approach enables a safe alternative even for larger tumors in the anterior rectal wall with a very low morbidity, sparing the patient from an unnecessary abdominoperineal resection.