A Case of Omental Tumour (GIST)

Dr A Rajasekar

A 40 year old lady was transferred from another hospital following laparotomy for suspected perforated appendix. Laparotomy had revealed a large abdominal tumour which was thought to be unresectable. On admission the patient's vital signs were stable. A CT scan of the abdomen was performed.

Figure 1 CT scan - large mass occupying the right side of the abdomen

Ultrasound guided Trucut biopsy of the mass was reported as suspicious of a benign neurilemmoma and a deeper biopsy was requested. Laparotomy was therefore performed.

Figure 2 Omental tumour

Figure 3 Tumour - arising from the omentum

Figure 4 Resected specimen

The tumour seemed to be arising from the omentum. The entire tumour, a segment of proximal small bowel and the greater omentum were removed. There were tumour depositis in the mesentry and on the peritoneum. Most of them were removed. The stomach, small bowel and large bowel were normal.

The pathology was reported as Omental Gastrointestinal stromal tumour (GIST). The tumour was spindle celled and was positive for CD34 and with focal positivity for SMA but negative for S-100protein and CytoK.