Giant oesophageal gastrointestinal stromal tumour presenting with dyspnoea and clubbed fingers.

Abstract

Gastrointestinal stromal tumours (GISTs) are mesenchymal neoplasms of the gastrointestinal tract originating from the interstitial cells of Cajal. Giant oesophageal GISTs are rare since the oesophagus is rarely the primary site of GISTs, and they are usually diagnosed early due to complaints such as dysphagia. We present the case of a giant oesophageal GIST presenting with prominent clubbing. The case underlined the diagnostic importance of clubbing and the careful consideration of chemotherapy. Although clubbed fingers associated with GISTs are rare, our experience demonstrates the importance of physicians' recognition of clubbing as a paraneoplastic phenomenon for early diagnosis of malignancies since patients seldom notice their own clubbing by themselves. Chemotherapy using imatinib, an Bcr-Abl kinase inhibitor, is the standard option for unresectable giant GISTs. However, careful consideration must be made of the risk of complications associated with rapid mass reduction due to imatinib such as bleeding, oesophageal perforation and mediastinitis.

• Authors: Yurie Yamamoto, Yosuke Sasaki, Michio Kougame, Naobumi Tochigi
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2017 (Jul 26 2017) ISSN: 1757-790X [Electronic] England
• PMID: 28751509 (Publication Type: Case Reports, Journal Article)
• Copyright: © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Topics

• Aged
• Dyspnea (diagnosis, etiology)
• Esophageal Neoplasms (complications, diagnosis, physiopathology)
• Fatal Outcome
• Gastrointestinal Stromal Tumors (complications, diagnosis, physiopathology)
• Humans
• Male
• Osteoarthropathy, Secondary Hypertrophic (pathology)
• Palliative Care
• Paraneoplastic Syndromes (pathology)