The gastrointestinal stromal tumor (GIST) is a mesenchymal tumor of the digestive tract showing differentiation along the line of interstitial cell of Cajal. The most GISTs in the stomach generally show the appearance of submucosal tumors. It is rare for GISTs to appear as a pedunculated polypoid lesion on endoscopy. We experienced a case of a 51-year-old man who had a pedunculated polypoid GIST. He was admitted to our hospital for nausea, vomiting, melena and severe anemia (hemoglobin 3.4 g/dL, hematocrit 10.8%). An upper endoscopy showed gastroduodenal intussusception due to a pedunculated polypoid mass. This report presents a rare case of endoscopically proven gastroduodenal intussusceptions due to pedunculated polypoid GIST in the stomach.
Duodenal Diseases/etiology/*pathology ; Gastrointestinal Hemorrhage ; Gastrointestinal Neoplasms/complications/*pathology ; Gastrointestinal Stromal Tumors/complications/*pathology ; Gastroscopy ; Humans ; Intussusception/etiology/*pathology ; Male ; Middle Aged ; Tomography, X-Ray Computed

To explore the differences in biological characteristics for the small gastrointestinal stromal tumors and the incidence of complications and recurrence between the traditional surgical treatment and endoscopic treatment.
 Methods: We collected the relevant clinical and pathological data from patients who were diagnosed as gastrointestinal stromal tumors with the diameter less than 2 cm by the Department of Pathology of Xiangya Hospital from January 2009 to December 2015. The complications and recurrence after the surgical treatment were analyzed.
 Results: In patients with small gastrointestinal stromal tumors, the proportion of female was higher than that of male (male:female=1:1.69). The median age for patient with this disease was 49 years old and it was more common in middle-aged and elderly. Most lesions were found in the stomach, followed by the esophagus and the small intestine. The small gastrointestinal stromal tumors occurred in the colon and rectum were rare. There was 60.3% (47/78) patients with abdominal pain, 7.7% (6/78) patients with hematochezia or melena, and 98.7% (78/79) with small gastrointestinal stromal tumors' mitotic count ≤5/50 HPF. The positive rates for CD, CD34, DOG-1, actin-smooth, and S-100 were 98.7%, 86.1%, 82.3%, 31.6%, and 24.1%, respectively. Three patients occurred surgical complications, 2 suffered recurrence during the follow-up. There was no significant difference in the incidence of complications and recurrence between the traditional surgical treatment and endoscopic treatment (P>0.05).
 Conclusion: Small gastrointestinal stromal tumors' malignant potential is low, and the recurrence and metastasis rate is low. Its biological behavior tends to be benign. The traditional surgical treatment and endoscopic treatment are both safe and effective for small gastrointestinal stromal tumor. Endoscopic treatment has the advantages in lower cost, shorter hospitalization time, and small trauma. Therefore, endoscopic treatment could be the first choice for small GIST resection under the condition of mature endoscopic technology.
Aged ; Endoscopy, Gastrointestinal ; Female ; Gastrointestinal Hemorrhage ; etiology ; Gastrointestinal Neoplasms ; complications ; pathology ; surgery ; Gastrointestinal Stromal Tumors ; complications ; pathology ; surgery ; Humans ; Incidence ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Postoperative Complications ; epidemiology ; Retrospective Studies ; Tumor Burden

Cowden's disease, also known as various hamartomatous malformations of multiple organs, is a rare autosomal dominant disorder. The most important feature of Cowden's disease is its frequent association with malignant neoplasm, particularly in the breast and thyroid gland. Cowden's disease with malignant neoplasms, is quite rare in Korea so far. We report a case of Cowden's disease associated with breast cancer in a 41-year-old female who underwent routine health cheek-up.
Adult ; Breast Neoplasms/*complications/pathology ; Colonoscopy ; Female ; Gastrointestinal Tract/pathology ; Gastroscopy ; Hamartoma Syndrome, Multiple/complications/*diagnosis ; Humans ; Polyps/diagnosis

Enteropathy-type T-cell lymphoma (ETTL) is a rare disease with a poor prognosis. According to the World Health Organization (WHO) classification, it is a subtype of the peripheral T-cell lymphomas. This disease is associated with gluten-sensitive enteropathy, has a high risk of intestinal perforation and obstruction, and is refractory to chemotherapeutic treatment. We report the case of a 73-year-old woman who was diagnosed with enteropathy-type T-cell lymphoma of the small intestine, which was positive for the markers of cytotoxic T cells, CD3, CD8, and CD56, on immunohistochemical staining after resection of the perforated terminal ileum.
Aged ; Celiac Disease/*complications/pathology ; Female ; Gastrointestinal Neoplasms/*complications/pathology ; Humans ; Intestinal Perforation/*diagnosis/*etiology/pathology ; Lymphoma, T-Cell/*complications/pathology

No abstract available
Colonic Neoplasms/complications/*pathology ; Colonic Polyps/complications/*pathology/surgery ; *Colonoscopy ; Gastrointestinal Hemorrhage/*etiology ; Hemangioma, Cavernous/complications/*pathology ; Humans ; Male ; Middle Aged

Enteropathy-associated T-cell lymphoma (EATL) is an unusual primary gastrointestinal lymphoma, particularly associated with celiac sprue. This tumor usually affects the jejunum and grossly presents as multiple circumferential ulcers without the formation of definite tumor masses. Moreover, mesenteric lymph nodes are commonly involved. The patients have typically suffered from abdominal pain, diarrhea, or weight loss whereas some patients may manifest with nonspecific symptoms for a period of years or an acute emergency of perforation, obstruction, or hemorrhage. The clinical course of EATL is very unfavorable and the prognosis is poor. Both celiac sprue and EATL are very rare diseases in Asia, except India and Middle East. We report a 60-year-old male diagnosed as having EATL after segmental small bowel resection, who presented with recurrent gastrointestinal bleeding.
Celiac Disease/*complications ; Gastrointestinal Hemorrhage/*etiology ; Humans ; Intestinal Neoplasms/complications/*diagnosis/pathology ; Intestine, Small/pathology ; Lymphoma, T-Cell/complications/*diagnosis/pathology ; Male ; Middle Aged ; Recurrence

There have been several published reports on metastatic lesions in the stomach, but the number of cases have been limited due to the low frequency of the condition. Metastatic lesions in the stomach are usually asymptomatic. A 55-year-old man with known metastatic lung adenocancer exhibited epigastric pain, hematemesis, and melena. A bleeding, ulcerated gastric metastasis was found and treated with endoscopic therapy and omeprazole.
Neoplasm Metastasis ; Middle Aged ; Male ; Lung Neoplasms/*complications/*diagnosis ; Humans ; Gastrointestinal Tract/*pathology ; Gastrointestinal Hemorrhage/diagnosis/*pathology ; Fatal Outcome ; Cell Nucleus/metabolism ; Adenocarcinoma/pathology ; Acute Disease

Carney triad is a rare syndrome of unknown etiology characterized by having at least two out of three following neoplasms: gastrointestinal stromal tumor, pulmonary chondroma and extra-adrenal paraganglioma. About 100 cases have been reported worldwide. We report a case of Carney triad in a 42-year-old woman presented with a gastrointestinal stromal tumor in the stomach and a malignant functioning paraganglioma in the retroperitoneum that was fatal five years after diagnosis. The gastrointestinal stromal tumor was diagnosed as intermediate-risk of aggressive behavior and diffusely positive for c-kit whereas the retroperitoneal paraganglioma was negative for c-kit. Genetic analyses showed no mutations of KIT, PDGFRA, SDHB, SDHC, and SDHD genes in both tumors. To our best knowledge, this is the first case of Carney triad in Korea.
Adult ; Carney Complex/*chemically induced/complications ; Female ; Gastrointestinal Stromal Tumors/*diagnosis/pathology ; Humans ; Korea ; Paraganglioma/*diagnosis/pathology ; Retroperitoneal Neoplasms/*diagnosis/pathology ; Stomach Neoplasms/*diagnosis/pathology

Intussusception is primarily a disease of children, and is relatively rare in adults. Unlike childhood intussusception, adult intussusception has an identifiable leading lesion such as malignant or benign neoplasm. However, intussusception caused by hemangioma is very rare. There were few cases of small bowel intussusception caused by hemangioma in adults, but those reports were presented with abdominal pain. This report describes a 65-year-old female who suffered from small bowel intussusception caused by hemangioma presenting with intestinal bleeding. Upper gastrointestinal endoscopy and colonoscopy were performed, but bleeding focus was not found. Abdominal computed tomography showed the target sign of small bowel with a leading point of mass. This mass turned out to be a hemangioma after the small bowel resection. Therefore, small bowel intussusception by hemangioma should be also considered as a bleeding focus when an adult patient presented intestinal bleeding without bleeding focus in the stomach and colon. Herein we report a case of small bowel intussusception caused by hemangioma presenting with intestinal bleeding.
Aged ; Diagnosis, Differential ; Female ; Gastrointestinal Hemorrhage/*etiology ; Hemangioma/*complications/pathology ; Humans ; Intestinal Neoplasms/*complications/pathology ; *Intestine, Small ; Intussusception/*diagnosis/etiology/pathology ; Tomography, X-Ray Computed

Brunner's gland adenoma is a rare tumor of duodenum. Patients are usually aymptomatic and most are discovered incidentally during the upper gastrointestinal (GI) series or esophagogastroduodenoscopy. These lesions are most commonly located in the duodenal bulb and clinical manifestations are variable. In symptomatic patients, the most common manifestations are GI hemorrhage and duodenal obstruction. On histologic examination, Brunner's gland adenoma that causes clinical symptoms is composed of hyperplastic Brunner's glands and contains mostly an admixture of glandular, adipose, and muscular tissues. We report a case of large Brunner's gland adenoma causing upper gastrointestinal hemorrhage in a 47-year-old woman which was successfully removed by endoscopic resection without complications such as bleeding or perforation. Microscopically, it was entirely composed of variable Brunner's glands.
Adenoma/complications/*pathology/surgery ; Brunner Glands/*pathology/surgery ; Duodenal Neoplasms/complications/*pathology/surgery ; Duodenoscopy ; Female ; Gastrointestinal Hemorrhage/etiology ; Humans ; Middle Aged