-Report on Experiments and Clinical Cases-

Spurt Bleeding from a Calcificated Gastrointestinal Stromal Tumor in the Stomach

Hiroshi Yoshida¹, Yasuhiro Mamada¹, Nobuhiko Taniai¹, Yoshiaki Mizuguchi¹, Yoshiharu Nakamura¹, Tsutomu Nomura¹, Takeshi Okuda¹, Eiji Uchida¹, Yuh Fukuda², Manabu Watanabe³ and Takashi Tajiri¹

¹Surgery for Organ Function and Biological Regulation, Nippon Medical School, Graduate School of Medicine
²Department of Analytic Human Pathology, Nippon Medical School, Graduate School of Medicine
³Uchida Hospital, Tokyo

Calcifications within primary gastrointestinal tumors are rare. Gastrointestinal stromal tumor (GIST) is an unusual nonepithelial tumor that develops in the gastrointestinal tract. In this paper we describe a case of spurt bleeding from a calcificated GIST in the stomach successfully treated by partial gastric resection.
A 77-year-old man was admitted for chest discomfort and loss of consciousness. Endoscopic examination revealed spurt bleeding from the top of the submucosal tumor. No other lesions or points of bleeding were found in the stomach. Emergency partial gastrectomy was performed, and the stomach was closed. The cut surface of the tumor had a firm, solid, whitish-gray parenchyma with patchy calcification. Microscopic observation revealed a profusion of spindle-shaped tumor cells with calcification growing from the gastric muscular propria to the submucosa. The cells exhibited low mitotic activity and no prominent signs of nuclear atypia. Immunohistochemical staining of the tumor demonstrated positive reactivity for CD34, KIT, and vimentin, but negative reactivity for α-smooth muscle actin, desmin, and S-100 protein. Tumor cells positive for Mib-1 were rare. The diagnosis of the tumor was established as GIST.

J Nippon Med Sch 2005; 72: 304-307

Keywords
gastrointestinal stromal tumor, stomach, bleeding, gastric resection, calcification

Correspondence to
Hiroshi Yoshida, MD, Department of Surgery 1, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
hiroshiy@nms.ac.jp

Received, June 3, 2005
Accepted, July 13, 2005