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 19 June 2018

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GastroenterologyStomach & duodenum

Benign tumors

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GIST tumor of the stomach.
A 74-year old woman who presented with melaena. An endoscopy showed an ulcerating tumor on the posterior wall of the stomach. This had the macroscopic appearances of a leiomyoma.

The operative view shows the tumor. The lesser sac has been entered and the stomach everted to show the tumor. The bulk of the tumor is outside the wall of the stomach and sits in the lesser sac. The surgeon's left index finger points to the posterior wall of the body of the stomach. The antrum is to the tip of the surgeon's left middle finger.

The tumor is excised with a linear stapler. Using this device, it is possible to avoid opening the stomach, thereby reducing the risk of contamination of the abdominal cavity.

Most of the resected specimen is outside the lumen of the stomach. The ulcerated apex can be seen. It contains fresh blood.

Still often referred to as 'leiomyomas,' these tumors are more accurately now classified as gastrointestinal stromal tumors (GIST)


Peter Devitt, Adelaide, Australia

GIST tumor of the stomach.

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