PMC5470555_01
Stage IV rectal gist found on CT of the Abdomen and Pelvis with diffuse liver metastases with asymmetric rectal mass measuring 3.6 cm x 6 cm in size.
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CT of the chest, abdomen, and pelvis for staging revealed diffuse metastatic disease to the liver, poorly circumscribed mass involving the rectum measuring 3.6 cm by 6.0 cm with two adjacent left-sided pathologic lymph nodes (Fig. 1).
Stage IV rectal gist histology revealed the tumor to be positive for CD117, CD34 and negative for CKAE1/AE3, CK7, CK20, synaptophysin, SM actin which was consistent with a GIST. The mitotic rate was 6 per 30 HPF or 8.3 per 50 HPF.
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The mitotic rate was 6 per 30 HPF or 8.3 per 50 HPF (Fig. 2).
Stage IV rectal gist found on CT of the Abdomen and Pelvis with a small right pulmonary nodule suggestive of metastases to the lung.
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Rectal mass found on colonoscopy which was biopsied and later found to be a Stage IV GIST rectal cancer.
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Physical exam revealed a palpable mass on rectal exam located at the 9-12 o'clock position 6 centimeters (cm) from anal verge visualized on anoscopy (Fig. 4).
Rectal perforation found on CT of the Abdomen and Pelvis with free air seen in the mesorectum.
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He presented to the emergency department two weeks later with abdominal pain and free air in his abdomen and imaging from outside hospital that revealed a rectal perforation (Fig. 6).