Coexistence GIST and Ulcerative Colitis in Patient with Dyspepsia and Rectorrhagia

Background: Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the digestive tract. GIST has received lots of attention over the last decade. IBD is a chronic inflammatory condition involving the gastrointestinal tract. It is well known that patients with IBD have a higher incidence of adenocarcinoma. In this paper we present a patient with IBD and asymptomatic GIST. Case presentation: A 32 year-old man with dyspepsia and rectorrhagia from some weeks ago underwent endoscopy and colonoscopy. Upper GI Endoscopy revealed a 2×2cm submucosal lesion at the gastric body. Endoscopic ultrasonography confirmed GIST and surgery was recommended. Colonoscopy diagnosed left side IBD (ulcerative colitis). Abdominal CT scan and sonography had no apparent abnormality. The pathology report confirmed low grade, spindle type GIST. Treatment was started with Oral Mesalazine and Asacol enema. As the abdominal and pelvic CT showed no metastasis, a complete surgical resection of the tumor performed and in a 6 months follow up, patient had no problem. Discussion: In IBD patients, treatment algorithms should focus on the prognostically relevant malignancies. Coincidence of ulcerative colitis and gastrointestinal stromal tumor is extremely rare. So, in cases with IBD diagnosis, GIST should be considered during further evaluation and differential diagnosis.by Ahmad Hormati in Shahid-beheshti-hospital, Qom, Iran