Retroperitoneal GIST

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INTRODUCTION: GIST can occur in all segments of the gastrointestinal tract with a predilection for the stomach. Retroperitoneal localization remains exceptional. We report a case to describe our diagnostic and therapeutic approach. CASE PRESENTATION: A 55-year-old patient was admitted with borborygms and a sensation of lumbar swelling for 6 months. He was diabetic and hypertensive. The clinical examination noted a right lumbar mass with perception of bowel sound anterior to the mass, with minimal discomfort and mobility. Ultrasound revealed a hypervascularised, encapsulated, well-limited retroperitoneal tissue mass in contact with the right psoas muscle. Abdomino-pelvic CT scan showed a large, hypervascularized, encapsulated, calcified tissue mass measuring 147 × 106 mm in close contact with the outer edge of the right psoas muscle, suspected of being malignant. MRI noted a suspicious process developed at the expense of the right psoas muscle in its lumbar and iliac portion suggestive of a psoas rhabdomyosarcoma. The patient underwent laparotomy with a retroperitoneal approach by lumbar incision. Histology and immunohistochemistry revealed a GIST expressing CD117. The patient was put on imatinib for 6 months. He is complaint-free after 4 months. DISCUSSION: Despite the rarity of retroperitoneal GIST, it should be considered in the presence of any retroperitoneal mass. This will allow for early management. CONCLUSION: Retroperitoneum is an exceptional location for GIST. Surgery remains the mainstay of curative treatment. Adjuvant imatinib reduces the risk of recurrence. The prognosis is usually good.

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