PMC5927812_01
A coronal view of the patient's abdomen on MRI-small bowel followthrough, showing a 3 cm lesion in the left lower quadrant.
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On the same admission, an MRI small bowel follow through reported a 3 cm small bowel lesion (Fig. 1) suggestive of a Meckel's diverticulum as a preceding isotope scan was positive for uptake in this region.
PMC5927812_02
An axial view of the patient's pelvis on CT scan, showing a large lesion centrally communicating with the bowel.
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This showed a large mass in the distal bowel (Fig. 2).
Large mass (9.1 cm), located on the distal one-third of the ileum, was resected along with adjacent ileum and corresponding mesentery.
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The 9.1 cm mass (Fig. 3) was sent to histopathology for diagnosis.
Histopathology results of the resected lesion. The tumour is confirmed GIST, given the spindle fibre arrangement of the lesion (A), and the fact that it is C-kit positive (B). Mucosal ulceration of the lesion (C) was also apparent, with a highly vascularised area deep to the mucosa (D);accounting for the intraluminal bleeding of this tumour.
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Histopathology confirmed the spindle cell nature of the resected lesion (Fig. 4A) and, along with positive staining with cKIT (Fig. 4B) and DOG1, confirmed this lesion was Additionally, at the enteric luminal surface of the lesion there was significant mucosal ulceration (Fig. 4C) and deep to this the tumour was highly vascular (Fig. 4D), which would have accounted for her presentation with a significant gastrointestinal bleed.
PMC5927812_03