Brian M Yan, Reetesh K Pai, Jacques Van Dam
Context Gastrointestinal stromal tumors of the pancreas are very rare. Only two case reports have been published, both with diagnoses made on surgical pathology. We present the first case of pancreatic stromal tumor diagnosed by endoscopic ultrasound guided fine needle aspiration. Case report A 47-year-old male presented with self limited nausea and vomiting. A CT scan revealed a subtle, hypervascular mass in the uncinate process of the pancreas. Endoscopic ultrasound confirmed the pancreatic mass and fine needle aspiration was performed giving a bloody sample. Cytology showed spindle cell proliferation with CD117 positive immunohistochemistry, confirming a pancreatic gastrointestinal stromal tumor. Conclusion We present a case of pancreatic stromal tumor diagnosed by endoscopic ultrasound guided fine needle aspiration. Although very rare in the pancreas, gastrointestinal stromal tumors should be considered in the differential diagnosis of solid pancreatic masses and blood aspirates. INTRODUCTION Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumor of the gastrointestinal GI tract and occur primarily in the stomach (40-50%) and small bowel (30-40%) [1, 2]. Primary GISTs of the pancreas are extremely rare and previously have only been diagnosed by surgical pathology [3, 4]. We describe the first case of pancreatic GIST diagnosed by EUS-guided FNA.
