An unusual cause of upper gastrointestinal bleeding: duodenal GIST. A case report and literature review

A duodenal GIST is an unusual cause of upper gastrointestinal bleeding. Duodenal GISTs are rare and constitute 5% of all GISTs. A significant percentage of duodenal GISTs are located in the third and fourth portion of the duodenum and may not be detected on routine upper endoscopy. Push enteroscopy is necessary to locate these lesions. It is extremely important to differentiate a duodenal GIST from other submucosal tumors like leiomyomas, leiomyosarcomas or leiomyoblastomas which may present in a similar manner, because the treatment and prognosis differ significantly. Appropriate histological and immunohistiochemical staining is required to confirm the diagnosis. Surgical resection is the treatment of choice and may involve limited resection or a pancreaticoduodenectomy. Adjuvant therapy with Imatinib has been shown to prolong survival in patients with GIST in general.