Gastrointestinal Stromal Tumor Presenting as Intra-abdominal Abscess: A Case Report and Literature Review

This case report describes an unusual presentation of gastrointestinal stromal tumor. Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the entire gastrointestinal tract. The stomach and small intestine are the two most commonly involved sites. The presenting symptoms of GIST depend on the size and location of the tumor. The tumors may be found asymptomatically during endoscopic examination, and symptomatic patients present with common symptoms including abdominal pain, a palpable mass, anemia, or overt gastrointestinal bleeding. Herein, we report an unusual case of GIST presenting as an intra-abdominal abscess. This is an unusual presenting symptom of GIST and is difficult to diagnose preoperatively. The preoperative X-ray and abdominal CT images suggested the patient to have a gas-forming abscess from perforated peptic ulcer disease, and emergency surgery was performed. The post-operative finding was a gastric GIST with marked tumor necrosis that mimicked an intra-abdominal abscess. A literature review revealed only 6 similar cases. Although rare, clinicians should consider the possibility of an infected GIST in the differential diagnosis of acute abdominal pain with fever. It may be difficult to use radiological examination alone to determine the etiology of an unexplained intra-abdominal perforation or abscess. Adequate antibiotic treatment and surgical intervention are required for the successful treatment of infected GIST.