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Hemothorax Due to a Ruptured Esophageal Gastrointestinal Stromal Tumor: Case Report

Overview
Journal Surg Case Rep
Specialty General Surgery
Date 2022 Aug 11
PMID 35951141
Authors
Shohei Ohki
Naoki Enomoto
Daiki Kato
Shusuke Yagi
Hitomi Wake
Kyoko Nohara
Hideki Miyazaki
Toru Igari
Norihiro Kokudo
Kazuhiko Yamada
Affiliations
Soon will be listed here.
Abstract

Background: Esophageal gastrointestinal stromal tumors (GISTs) are rare tumors of the gastrointestinal interstitium, and comprise less than 0.7% of all GISTs. The presentation of esophageal GIST is relatively benign, commonly characterized by symptoms of dysphagia and gastrointestinal bleed. On the contrary, it is highly unusual for these tumors to present as surgical emergencies.

Case Presentation: Here, we describe a case of hemothorax secondary to the rupture of a massive (19 cm) esophageal GIST in a 79-year-old male. The patient presented with mild back pain, vomiting, and hypotension. A CT scan revealed significant mediastinal enlargement and left hemothorax. We conducted an emergency thoracotomy which revealed a 19 × 15 × 7 cm ruptured esophageal tumor that was bleeding profusely into the left thoracic cavity. Piecemeal resection without esophagectomy was performed to achieve hemostasis. Pathological evaluation of resected tissue confirmed the diagnosis of GIST. The patient was provided adjuvant imatinib therapy and remains progression-free at the 10-month follow-up.

Conclusions: To the best of our knowledge, this is the first reported case of life-threatening hemothorax caused by a ruptured esophageal GIST. Findings from this case may aid in the diagnosis and management of these rare tumors.

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