PMC5733166_01
Sagittal (a), axial (b), and coronal (c) images of CT with IV contrast showing the large, lobulated primary mass that was discovered in January 2013.
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Abdominopelvic CT scan revealed a complex, lobulated, enhancing, intraperitoneal mass measuring 18 x 19 x 10 cm, extending from the umbilicus to the level of the superior acetabulum (Figure 1).
Axial CT images demonstrating recurrent lesions (white arrows) in the left lower quadrant (a), adherent to the anterior abdominal wall (b), and in the right upper quadrant (c).
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In May 2016, surveillance CT revealed a 3.5 x 2.8 cm left lower quadrant mass abutting the sigmoid colon (Figure 2).
(a) Gross specimen of right upper quadrant recurrent GIST lesion. (b) Anterior abdominal wall mass (white arrow) adherent to the resected loop of the small intestine. (c) Small nodule within the mesentery discovered on diagnostic laparoscopy and resected. (d) Gross specimen demonstrating necrotic sigmoid lesion (white arrow) adherent to resected sigmoid.
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In late July 2016, diagnostic laparoscopy was performed (detecting a right lower quadrant peritoneal nodule), followed by laparotomy, small bowel resection, resection of right upper quadrant lesion, sigmoidectomy, and resection of right lower quadrant peritoneal nodule (Figure 3).