Gastrointestinal stromal tumors (GISTs) arising in the duodenum represent a rare entity and can be very demanding to manage. The diagnosis can be difficult (as these tumors can be misdiagnosed as pancreatic head tumors), and to treat owing to the complex anatomy of the duodenum and of the pancreatic head. Complete resection may require extensive procedures such as pancreaticodudodenectomy.
Gastrointestinal stromal tumors(GISTs) represent the most common tumor of mesenchymal origin arising in the gastrointestinal tract (GI tract). They often express c-kit protein and react with CD-117 antibody.1, 2 These tumors can arise everywhere in the GI tract, even though they are more frequently found in the stomach (about 60%), small bowel (about 25%), colon and rectum (about 10%), while only 3–5% of GISTs occur in the duodenum . There are only sporadic reports of extra-gastrointestinal stromal tumors (e-GISTs) arising in the omentum , mesentry or retroperitoneum.
The clinical presentations of duodenal GISTs are highly variable, and they are related to their origin, growth (intramural or extramural), and size. The most common clinical presentations are gastro intestinal bleeding (when mucosal ulceration is present), and abdominal pain. These tumors are often diagnosed incidentally, as they can be asymptomatic, especially for small tumors, or when the tumor growth is extraluminal. Some authors described back pain , jaundice (compression of common bile duct), or bowel obstruction, but these events are very rare.