HIGH-GRADE GASTRIC CARDIA GIST PRESENTING WITH DYSPHAGIA: A CASE REPORT
TL;DR
Gastric cardia GIST may rarely present with dysphagia due to mass effect near the gastroesophageal junction, and minimally invasive surgical excision with negative margins is feasible even for relatively large proximal gastric GISTs.
Abstract
Background: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. Gastric GISTs usually present with abdominal pain, gastrointestinal bleeding, or incidental findings on imaging. Dysphagia is an uncommon presenting symptom and is rarely associated with gastric cardia GISTs. Case Presentation: We report the case of a 58-year-old male who presented with progressive dysphagia and weight loss. Contrast-enhanced computed tomography revealed a 6 × 6 cm exophytic mass arising from the gastric cardia. Upper gastrointestinal endoscopy demonstrated external compression near the gastroesophageal junction without mucosal ulceration. The patient underwent successful laparoscopic excision of the tumor with primary gastric closure. Histopathological examination confirmed a high-grade gastrointestinal stromal tumor with spindle cell morphology. Immunohistochemistry was positive for CD117 and DOG1. The postoperative period was uneventful. Adjuvant imatinib therapy was initiated, and follow-up imaging at 6 months showed no evidence of recurrence. Conclusion: Gastric cardia GIST may rarely present with dysphagia due to mass effect near the gastroesophageal junction. Minimally invasive surgical excision with negative margins is feasible even for relatively large proximal gastric GISTs. Early diagnosis, complete resection, and adjuvant targeted therapy are essential for favorable outcomes in high-risk tumors.