Surgical Management of a High-Grade Gastrointestinal Stromal Tumor in a Morbidly Obese Patient: A Case Study

Gastrointestinal stromal tumors (GISTs) are the most commonly occurring mesenchymal tumors within the gastrointestinal (GI) tract yet, those located at the gastroesophageal junction (GEJ) are rare. We present a 31-year-old woman with morbid obesity and large (4.9 cm) polypoid mass adjacent to the GEJ. She was offered a laparoscopic transgastric GIST resection and adjuvant imatinib. Intraoperatively, a gastrotomy was created through which the polypoid tumor was successfully delivered for resection. The increasing prevalence of obesity can pose unique challenges to peri-operative management. Thoughtful innovations in surgical approach can save obese patients from increased morbidity or surgical delay.