case_images: PMC10907077_01
case_images: Duodenal gastrointestinal stromal tumour (GIST) on computed tomography (CT) angiogram of the abdomen, coronal view
case_images: cureus-0016-00000053331-i01.jpg
case_images: PMC10907077_01_cureus-0016-00000053331-i01.jpg
case_images: FIG1
case_images: Following surgical review, they proceeded with a CT scan angiogram (Figures 1-2) of the abdomen, which revealed a hypervascular intraluminal lesion related to the distal 2nd part of the duodenum with no convincing evidence of active bleeding.
case_images: Duodenal gastrointestinal stromal tumour (GIST) on computed tomography (CT) angiogram of the abdomen, axial view. Arrowhead points to the gastrointestinal stromal tumour (GIST)
case_images: cureus-0016-00000053331-i02.jpg
case_images: PMC10907077_01_cureus-0016-00000053331-i02.jpg
case_images: FIG2
case_images: Following surgical review, they proceeded with a CT scan angiogram (Figures 1-2) of the abdomen, which revealed a hypervascular intraluminal lesion related to the distal 2nd part of the duodenum with no convincing evidence of active bleeding.
case_images: Lesion suggestive of gastrointestinal stromal tumour (GIST) on oesophagogastroduodenoscopy (OGD) marked by an arrow
case_images: cureus-0016-00000053331-i03.jpg
case_images: PMC10907077_01_cureus-0016-00000053331-i03.jpg
case_images: FIG3
case_images: It was suggestive of a GIST (Figure 3).
case_images: Fine needle biopsy of a submucosa from the lesion in the second part of the duodenum stained with haematoxylin and eosin. A: Under low power microscope, the specimen contained cores of blood and slender cores of a spindle cell lesion. B: Under high power microscope, spindle cells are arranged in fascicles and nuclei are relatively uniform
case_images: cureus-0016-00000053331-i04.jpg
case_images: PMC10907077_01_cureus-0016-00000053331-i04.jpg
case_images: FIG4
case_images: Biopsy results showed fragments of epithelial cells and the core of spindle cells (Figure 4).
case_images: Immunohistochemistry of the lesion. Immunohistochemistry showed the lesion to be DOG1 positive, moderately CD117 (c-kit)+, and SMA+. D33 (confirming that this is not a smooth muscle tumour) and S-100 were negative (confirming that this is not of neural origin). DOG1 positivity confirms gastrointestinal stromal tumour (GIST). CD117 presence adds certainty and dictates possible treatment options. SMA may have seen some GISTs too. A: DOG1 positive. B: S100 negative. C: D33 negative. D: SMA positive. E: CD117 positive. F: CD34 positive
case_images: cureus-0016-00000053331-i05.jpg
case_images: PMC10907077_01_cureus-0016-00000053331-i05.jpg
case_images: FIG5
case_images: The Ki-67 index was between 2 and 2.5 (Figure 5).