Giant gastrointestinal stromal tumor of the stomach

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract, accounting for 1–2% of all GI malignancies. They arise from interstitial cells of Cajal. Gastric GISTs usually become symptomatic at around 6 cm, whereas giant gastric GISTs (>15 cm) are rare. We report a 62-year-old male with four months of persistent epigastric pain. Imaging showed a large multinodular mass with irregular contrast enhancement. A distal subtotal gastrectomy with Billroth II and Braun reconstruction was performed. Pathology revealed a mixed-cell-type GIST, positive for CD117, CD34 and vimentin. The tumor was classified as 6b by risk criteria and T4N0M0 by TNM. Postoperative recovery was uneventful, adjuvant imatinib 400 mg/day was initiated, and no tumor progression was observed during 12 months of follow-up.