A gastrointestinal stromal tumour in the distal ileum-a rare presentation in Saudia Arabia: case report.

Introduction: Gastrointestinal stromal tumours (GIST) are an extremely rare case in Saudi Arabia. These tumours arise from the smooth muscle cells of Cajal in the interstitium, a key component of Gastrointestinal tract (GIT) mesenchymal tissue. Case report: A 31-year-old male arrived at our emergency department with central abdominal pain, nausea, vomiting, and absolute constipation persisting for four days. Upon examination, he exhibited hypotension, tachycardia, and tenderness in the central abdomen. The provisional working diagnosis based on the abdomen computed tomogram (CT) indicated a pelvic tumour to the right of the lower midline. Contrast CT suggested a distal ileum inflammatory mass vs. a tumour. Operative results verified a tumour at the distal ileum accompanied by a dilated, obstructed volvulus in the small bowel. A histoinmunohistochemical analysis showed the presence of a gastrointestinal stromal tumour (GIST), demonstrating diffuse positivity for CD117 (Ckit), focal positivity for CD34, and negative results for S100 and desmin. Conclusion: It is critical to avoid tumour rupture during surgical resection, as this may result in tumour implantation or recurrence. Because the tumour was fragile and fragmented during dissection, a positive outcome may not be possible; consequently, our case requires strict surveillance and CT follow-up. The operating surgeon and histopathologist must agree on labelling specimens before sending them to the lab. Furthermore, research must investigate epidemiological issues, therapeutic methods, and follow-up procedures in Saudi Arabia. Guidelines for managing and following up on these cases should be developed based on the agreed-upon processes.