ArticleInternational medical case reports journal2026
Gastrointestinal Stromal Tumor (GIST) Arising in the Setting of a Large Hiatal Hernia: A Case Report.
Article in International medical case reports journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The occurrence of a gastric neoplasm within a hiatal hernia is a rare clinical entity that poses significant diagnostic challenges. While imaging may initially suggest more common malignancies like adenocarcinoma, gastrointestinal stromal tumors (GISTs) should be considered as a critical differential diagnosis due to their distinct management implications. Case Presentation: A 53-year-old Somali male presented with fatigue, dizziness, early satiety, and shortness of breath on exertion. CT revealed a large hiatal hernia with an 8.4×6.5 cm heterogeneous mass arising from both the herniated and non‑herniated portions of the gastric wall, and extending into the esophageal lumen. Endoscopic biopsies were non-diagnostic. Surgical resection confirmed a high-risk GIST (pT4, 8.4 cm, mitotic index 8/50 HPF). The patient received adjuvant imatinib 400 mg daily. Follow-up CT on August 10, 2025, showed a 6.2×6.0 cm recurrent lesion. Conclusion: A hiatal hernia with mass should prompt a strong suspicion for malignancy. Although gastric adenocarcinoma is more commonly suspected, GIST should remain an important differential. This case highlights the essential role of immunohistochemistry in achieving a definitive diagnosis and underscores the aggressive nature of high-risk GISTs. This necessitates complete surgical resection, consideration of adjuvant therapy, and rigorous radiological surveillance.
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