A Case of Giant Esophageal Gastrointestinal Stromal Tumor that was Successfully Resected without Neoadjuvant Treatment

Abstract

A 27-year-old male from Gaza was admitted to the Gastroenterology department with complaints of progressive dysphagia. An endoscopic examination shows submucosal gastric mass at the Gastro-Esophageal (GE) junction. Physical examination was normal. There was no abnormalitie found in laboratory examinati ons, including hematologic and biochemical analyses. A whole abdominal enhanced Computed Tomography (CT) scan revealed a solid mass with a smooth border and hypervascularity at the gastro-esophageal junction. Endoscopic ultrasound guided fine needle biopsy was performed, pathologic diagnosis of the submucosal tumor was GIST. The patient was considered for neoadjuvant immunotherapy, but then he is excluded due to logistic considerations. The patient underwent distal esophagectomy and proximal gastrectomy, complete resection was performed and the specimen was sent for histopathology. The diagnosis of an esophageal GIST with negative margins was confirmed by histological investigation of the resected specimen. Spindle-shaped tumor cells were discovered in the tumor. CD34 and DOG1 were shown to be positive in the tumor cells by immunohistochemistry. In 50 high-power fields, the