PMC6796651_01
Abdominal contrast-enhanced computed tomography findings.. A sharp border and homogeneous mass (arrows) are seen in the arterial phase, suggesting a gastrointestinal stromal tumor of the mesentery.
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Abdominal contrast-enhanced CT revealed a sharp border and homogeneous mass, indicating GIST of the mesentery (Fig. 1).
a. The abdominal mesh detected via laparoscopy. The edge of the mesh (arrows) could be detected. b. Laparoscopy findings. Laparoscopy revealed that the tumor (arrows) origin as the transverse colon (arrowheads). c. Anastomosis findings during laparotomy. The side-to-side anastomosis of the colons using a linear stapler is performed. d. Enterotomy findings during laparotomy. The enterotomy site is closed with a linear stapler by using the intraabdominal sutures as a guide.
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System 5 mm) into the left and right upper quadrants, and two 12-mm ports (Kii Access System 12 mm) into the left and right lower quadrants, under a pneumoperitoneum of 10 mmHg, with a view of the laparoscopic image. Subsequently, laparotomy revealed the tumor in the transverse colon; thus, a transverse colectomy with minimal resection was planned (Fig. 2b). Thereafter, a small enterotomy was made on the antimesenteric sides of these portions of the colon, and a linear stapler was inserted through the enterotomy site so that a side-to-side anastomosis could be performed (Fig. 2c). The enterotomy site was then closed roughly with three intraabdominal sutures, and using the elevation of the sutures as a guide, the site was closed completely using the linear stapler (Fig. 2d).
a. Macroscopic findings of the resected specimen. The resected specimen shows a smoothly marginated tumor (arrows) that is 55 x 35 x 30 mm on the serosal side (arrowheads indicate oral side of resected margin). b. Microscopic pathology findings (hematoxylin eosin stain of the resected specimen). The resected specimen shows spindle cells (arrows) in the proper muscle layer which tested positive for smooth muscle actin and negative for DOG1, CD34, desmin, CD56, CD117 (c-kit), and synaptophysin.
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The resected specimen showed a tumor measuring 55 x 35 x 30 mm with smooth margins on the serosal side (Fig. 3a). Upon immunostaining, the tumor was positive for smooth muscle actin and negative for DOG1, CD34, desmin, CD56, CD117(c-kit), and synaptophysin (Fig. 3b).