Obstruction of the bile ducts due to a gastrointestinal stromal tumor in the duodenum. Case report

Abstract

Introduction: Gastrointestinal stromal tumors generally have a long silent period until clinical manifestation and expansive growth that displaces neighboring structures without invading them.

Objective: to present a case with bile duct obstruction due to extrinsic compression caused by a gastrointestinal stromal tumor of the duodenum.

Presentation of the case: a 63-year-old male patient, with a history of complicated acid-peptic disease, who by chance was detected an image in the projection of the head of the pancreas that suggested the existence of a gastrointestinal stromal tumor, confirmed by histological and immunohistochemistry analysis. The multidisciplinary care team considered the tumor unresectable due to vascular compromise and high morbidity due to advanced disease, for which neoadjuvant therapy with imatinib was instituted. Months later, a secondary biliary obstructive condition to extrinsic tumor compression led to the death of the patient.

Conclusions: Gastrointestinal stromal tumors constitute a diagnostic challenge for primary care professionals, requiring early and rapid management of affected patients, both from a clinical and imaging point of view. A clinical case is contributed to the literature that reveals the deleterious effects of late diagnosis in advanced stages of these tumors, which prevents the implementation of therapeutic options that allow greater survival of patients affected by cancer.