Volume 193 - Issue 3
Cutaneous marker of an upper gastrointestinal bleed
Authors: Pazhanivel Mohan, Mohan Kaduganoor Ramakrishnan and Jayanthi Venkataraman
Med J Aust 2010; 193 (3): 179. || doi: 10.5694/j.1326-5377.2010.tb03840.x
Published online: 2 August 2010
Published online: 2 August 2010
A 38-year-old woman presented with sudden onset of haematemesis and melaena. She had no abdominal pain or jaundice, and she had not taken drugs before the bleed. On examination, she had cutaneous features of neurofibromatosis (Figure, A). Upper gastrointestinal endoscopy showed a smooth polypoidal mass, with central umbilication, in the body of stomach (Figure, B). A contrast-enhanced computed tomography scan of the abdomen showed an exophytic mass confined to the stomach. Following another haematemesis, the patient underwent an emergency sleeve resection of the mass. Histopathological examination of the removed tissue revealed spindle-shaped neoplastic cells with elongated nuclei arranged in fascicles (Figure, C), and immunostaining (Figure, D) was positive for CD117 (c-KIT), confirming gastrointestinal stromal tumour (GIST).
The prevalence of GIST in neurofibromatosis type 1 (NF1) varies between 4% and 25%.1 The clinical presentation of GIST associated with NF1 is similar to sporadic GIST but differs in being multiple; large, often involving the small intestine; and having a favourable prognosis.1 Several cutaneous syndromes are associated with gastrointestinal haemorrhage as a prominent feature. Prompt recognition of these disorders is required as early intervention can be life saving.
References
- Mittal A, Felter D, Shiller SM, et al. Gastrointestinal bleeding and cutaneous nodules. Proc (Bayl Univ Med Cent) 2008; 21: 331-334. 0_BEIGDFGC
Early-Onset Colorectal Cancer With Liver-Only Metastases: A Retrospective Cohort Study Integrating Prospectively Collected Real-World Clinical and Molecular Data From an Australian National Database (2009–2024) to Guide Treatment Planning
Savio G. Barreto, Christos S. Karapetis, Shahid Ullah, Matthew Burge, Susan Caird, Angus Campbell, Azim Jalali, Ross Jennens, Muhammad A. Khattak, Belinda Lee, Stephanie H. Lim, Shehara Mendis, Louise Nott, Timothy J. Price, Jeremy D. Shapiro, Jeanne Tie, Javier Torres, Colin Williams, Rachel Wong, Vanessa Wong, Peter Gibbs
Australian Pathways for Specialist Pain Management and Early Palliative Care for People With Pancreatic Cancer: Developed Using a Community Consensus Approach
Jennifer Philip, Melanie R. Lovell, Kylee Bellingham, Gail Garvey, Gregory B. Crawford, Nicole M. Rankin, Kara Burns, Isabel Young, Vivienne Milch, Dorothy Keefe, Katrina Anderson, James Lawson, Meinir Krishnasamy
Cause‐specific mortality among Queensland people with cirrhosis, by cirrhosis aetiology and decompensation status, 2007–22: a retrospective cohort study
Vikas Bhasker, Jessica R Fong, Paul J Clark, Gunter F Hartel, Richard Skoien, James O’Beirne, Elizabeth E Powell, Patricia C Valery
Clinical practice guidelines for hepatocellular carcinoma surveillance for people at high risk in Australia: summary of recommendations
Jacob George, Nicole L Allard, Stuart K Roberts, Leon A Adams, Jane Davies, Behzad Hajarizadeh, Jennifer H MacLachlan, Suzanne E Mahady, Rosalie Altus, Catherine Brown, David C Fry, Belinda Greenwood‐Smith, Natali Smud, Patricia C Valery, Nafisa Yussf, Kate Broun, Denise Campbell, Karen Canfell, Chelsea Carle Harrison, Victoria Freeman, Paul Grogan, Catherine Holliday, Suzanne Hughes, Anna Kelly, Cathelijne Kemenade, Claire Latumahina, Amanda McAtamney, Megan Varlow, Joachim Worthington, Susan Yuill, Eleonora Feletto
Assessment of metabolic dysfunction‐associated fatty liver disease in primary care: a consensus statement summary
Leon A Adams, William W Kemp, Kate R Muller, Elizabeth E Powell, Stuart K Roberts, Luis Calzadilla Bertot, Stephanie Best, Gary Deed, Jon D Emery, Samantha L Hocking, Graham R Jones, John S Lubel, Sinead Sheils, Stephen M Twigg, Gerald F Watts, Jacob George
Treatment outcomes for people with hepatitis C referred to tertiary care in Victoria, 2021–22: a retrospective observational study
Elly Layton, Nicole Matthews, Brendan Quinn, Nasra Higgins, Gabrielle Lindeman, Mielle Abbott, Jennifer MacLachlan, Elizabeth Birbilis, Margaret E Hellard, Joseph Doyle, Benjamin C Cowie, Mark Stoové