Small Bowel Gastrointestinal Stromal Tumor as a Gateway for Streptococcus anginosus Causing Multiple Liver Abscesses
| Autor: | Jonathan S Harmon, Michael Levitt, Angelo A Chinnici, Elsa Marisol Pichardo, Fernando Brea Parrilla, Gabriella A Conte, Rachel A Masia, Xiu Sun, Diane Marchesani |
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| Rok vydání: | 2020 |
| Předmět: |
Cancer Research
Gastrointestinal bleeding Abdominal pain medicine.medical_specialty Case Report Gastroenterology Gleevec 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Gastrointestinal stromal tumors Gastrointestinal tract GiST biology business.industry CD117 Small bowel medicine.disease digestive system diseases Liver abscess Imatinib mesylate Oncology Streptococcus anginosus 030220 oncology & carcinogenesis biology.protein 030211 gastroenterology & hepatology medicine.symptom business |
| Zdroj: | World Journal of Oncology |
| ISSN: | 1920-454X 1920-4531 |
| DOI: | 10.14740/wjon1270 |
| Popis: | Gastrointestinal stromal tumors (GISTs) are the most common type of mesenchymal neoplasm of the gastrointestinal tract but consist of only 1% of all primary gastrointestinal neoplasms. Differentiated from other spindle cell tumors, GISTs are uniquely positive for CD117 expression which allows for molecular targeting therapy with imatinib mesylate (Gleevec). Clinical presentations are variable, ranging from asymptomatic to vague symptoms of abdominal pain, early satiety, abdominal distention or gastrointestinal bleeding. Very rarely, patients can present with tumor-bowel fistula and intra-abdominal abscesses. In this article, we discuss a rare presentation of a middle-aged male with multiple liver abscesses found to have a primary small bowel GIST. This patient received prompt intravenous antibiotics; however, hepatic abscesses can be easily misinterpreted as cystic hepatic metastases which can delay appropriate therapy. Streptococcus anginosus was found to be responsible for the formation of the liver abscesses visualized on computed tomography (CT) scan. Similar to Streptococcus bovis, knowledge in the literature is arising about the association between S. anginosus and gastrointestinal malignancies. This case highlights the importance of identifying concomitant primary GISTs with intra-hepatic abscesses, as these lesions can be easily misconstrued as liver metastases and consequently mismanaged. We herein emphasize that hepatic abscesses are a potential sequela of GISTs and should thus prompt further investigation for potential malignancies, if warranted, so that there is no delay in treatment of these gastrointestinal tumors. |
| Databáze: | OpenAIRE |
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