Gastrointestinal Stromal Tumor Presenting Uncommonly as an Intra-lesional Bleed after Antiplatelet Therapy: A Case Report
Published: 2023-02-03
Page: 10-16
Issue: 2023 - Volume 6 [Issue 1]
Masood Karim
Department of Gastroenterology, The Aga Khan University Hospital, Pakistan.
Zahabia Sohail
Department of Gastroenterology, The Aga Khan University Hospital, Pakistan.
Shazaf Masood Sidhu *
Department of Internal Medicine, Fauji Foundation Hospital, Rawalpindi, Pakistan.
Rustam Khan
Department of Gastroenterology, The Aga Khan University Hospital, Pakistan.
Asma Yaseen
Department of Gastroenterology, The Aga Khan University Hospital, Pakistan.
*Author to whom correspondence should be addressed.
Abstract
Background: Gastrointestinal stromal tumors (GISTs) are rare but the most common mesenchymal tumors of the gastrointestinal tract. It has a variable clinical presentation, making early diagnosis difficult. We report a rare case of intra-lesional bleed as the initial presentation of gastric GIST.
Case Presentation: A middle-aged male patient, presented with the diagnosis of ST-elevation Myocardial Infarction. Angioplasty was done and he was kept on multiple blood thinners. Post-procedure, he became unstable and dropped hemoglobin level. Gastroscopy revealed submucosal gastric mass but no source of active bleeding was found. CT angiogram revealed intra-tumoral bleed within the mass. Hence, CT-guided empiric arterial embolization was done before mass would have ruptured. Later, the mass biopsy revealed GIST. Patient was thereafter managed with surgical resection and chemotherapy.
Conclusion: This is an unusual initial presentation of GIST. Life-threatening complications of GIST rupture can be prevented if diagnosed early.
Keywords: Gastrointestinal stromal tumor, intra-lesional bleed, trans-catheter arterial embolization