Alfaisal University, Saudi Arabia
Haya Azouz is a Medical Student at Alfaisal University. She is acting as Vice President for Dermatology Student Club. She is interested in Cardiology, Dermatology and Clinical Chemistry. She has many research and review publications. She recently prepared a literature review titled “Hepatic inflammatory pseudotumor presenting in an 8-year-old boy: A case report and review of literature”.
Gastrointestinal stromal tumors (GISTs) are rare neoplasms of the gastrointestinal (GIT). The occurrence of these neoplasms ectopically outside the GI tract is extremely uncommon. Only one case of primary adrenal GIST has been described in the literature. In this account, we report a second case of primary adrenal GIST in a 34-year-old male who presented with 5-week history of gradually progressive left flank pain and early satiety. Physical examination was notable for a moderately enlarged and tender mass involving the left flank region. All laboratory tests including complete blood count, renal, bone, hepatic, coagulation and tumor profiles were normal. Whole-body positron emission tomography (PET)/computed tomography (CT) scan showed a 14 x 11 cm hypermetabolicfluorodeoxyglucose (FDG) avid mass lesion involving the left adrenal gland and dorsal part of the left hemi-diaphragm. There was no evidence of distant metastasis. In consideration of a neoplastic lesion, an ultrasound-guided core-needle biopsy revealed tumor cells that were immunoreactive to CD-117 (c-kit) and CD-34, and negative to CD-31, S-100, cytokeratin, desmin and vimentin features characteristic of GIST. Surgical resection was advised, but patient refused. Subsequently, patient was offered imatinib (a tyrosine-kinase inhibitor). Surgical resection was advised, but patient refused. Subsequently, patient was offered imatinib (tyrosine-kinase inhibitor). Following therapy, a 3-month follow-up PET or CT scan showed markedly near-complete resolution of the metabolic activity of the known left adrenal mass lesion. Moreover, patient reported markedly reduced left flank symptoms. Although rare, GIST arising from adrenal gland can be confused with GIST arising from the greater curvature of stomach.