case_images: PMC9841066_01
case_images: Plain film of the abdomen. The long arrow shows multiple air-fluid levels, and the short arrow shows distended small bowel loops.
case_images: cureus-0015-00000033806-i01.jpg
case_images: PMC9841066_01_cureus-0015-00000033806-i01.jpg
case_images: FIG1
case_images: An initial abdominal X-ray was done and showed an air-fluid level with small bowel dilatation and shifting of small bowel loops to the left side of the abdomen (Figure 1).
case_images: CT scan of the abdomen. (A) Coronal view: The long arrow shows a large irregular necrotic mass (most probably a gastrointestinal stromal tumor) measuring about 17.2 x 10.7 x 18.2 cm (mediolateral x anteroposterior x craniocaudal). (B) Transverse view: The short arrows show multiple air-fluid levels at small intestine loops suggestive of small bowel obstruction.
case_images: cureus-0015-00000033806-i02.jpg
case_images: PMC9841066_01_cureus-0015-00000033806-i02.jpg
case_images: FIG2
case_images: No pneumoperitoneum could be noted (Figure 2).
case_images: Plain film of the chest. The arrow shows consolidation in the lower lobe of the right lung suggesting aspiration pneumonia.
case_images: cureus-0015-00000033806-i03.jpg
case_images: PMC9841066_01_cureus-0015-00000033806-i03.jpg
case_images: FIG3
case_images: A portable chest X-ray was done and showed consolidation in the right lower lobe, suggesting aspiration pneumonia (Figure 3).
case_images: Histopathological slides of the specimen. (A, B) Hematoxylin and eosin (H&E) stain with magnifications of x20 and x40, respectively, shows a tumor composed predominantly of spindle cells with intracytoplasmic vacuoles, moderate nuclear pleomorphism, and increased mitotic activity reaching up to 39/5 mm2. (C) Section with magnifications of x20 shows CD34 strong membranous positivity. (D) Section with magnifications of x20 shows DOG1 strong cytoplasmic and membranous positivity.
case_images: cureus-0015-00000033806-i04.jpg
case_images: PMC9841066_01_cureus-0015-00000033806-i04.jpg
case_images: FIG4
case_images: In addition, all the resection margins of the mass were free of tumor cells (Figure 4).