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Surgical specimen. The resected specimen includes the jejunal loop and the perforated GIST arising from the antimesenteric side of the loop. The arrow indicates the ruptured margin of the tumour. The insert shows the histology of the specimen: the perforation to the lumen of the jejunum is indicated by the arrow.
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A small layer of free extraluminal air was also seen close to the margin of the mass (Fig. 1).
Preoperative computed tomography (CT). (a) CT image showing air in the perforation track of the tumour (arrow); (b) CT image showing free air and intraperitoneal free fluid (arrow) around the jejunal tumour.
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Treitz ligament, on the antimesenteric side of the first jejunal loop (Fig. 2). The perforation was identified on the external border of the mass.
Histological findings. (a) H&E staining shows spindle-shaped cell proliferation; (b) immunoistochemical staining shows positivity for c-kit.
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H&E staining showed spindle-shaped cell proliferation (Fig. 3a). The immunohistochemical staining was positive for C-KIT (Fig. 3b), focal positive for h-caldesmon, negative for smooth muscle actin, desmin, CD34, S-100, EMA and cytocheratine.