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Subepithelial rectal gastrointestinal stromal tumor – the use of endoscopic ultrasound-guided fine needle aspiration to establish a definitive cytological diagnosis: a case report

Overview of attention for article published in Journal of Medical Case Reports, March 2017
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Title
Subepithelial rectal gastrointestinal stromal tumor – the use of endoscopic ultrasound-guided fine needle aspiration to establish a definitive cytological diagnosis: a case report
Published in
Journal of Medical Case Reports, March 2017
DOI 10.1186/s13256-017-1205-7
Pubmed ID
Authors

Vitor Ottoboni Brunaldi, Martin Coronel, Danielle Azevedo Chacon, Eduardo Turiani Hourneaux De Moura, Sérgio E. Matuguma, Eduardo Guimarães Hourneaux De Moura, Diogo Turiani Hourneaux De Moura

Abstract

Gastrointestinal stromal tumors are the most common mesenchymal neoplasms affecting the gastrointestinal tract. The stomach is the most common location to be affected, and the rectum one of the rarest, but the whole gastrointestinal tract remains susceptible. Gastrointestinal stromal tumors account for only 0.1% of rectal tumors. Currently, endoscopic ultrasound plays an essential role in the diagnostic process of gastrointestinal stromal tumors, especially when the affected sites have a worse outcome and higher morbidity rates. We describe the case of a 68-year-old white Japanese man with a history of long-term mild rectal pain and tenesmus. A digital rectal examination revealed a right palpable solid mass ranging from 3 to 7 cm from his anal verge. A colonoscopy was performed and showed a 5 cm elevated lesion covered by normal mucosa, located 4 cm above the pectineal line. Endoscopic ultrasound confirmed the diagnosis of a homogeneous hypoechoic mass with areas of necrosis as a rectal subepithelial lesion originating at the fourth layer (muscularis propria). He then underwent endoscopic ultrasound-guided fine needle aspiration of the lesion, followed by cytological and immunohistochemistry evaluation. The evaluation showed spindle and epithelioid cells of variable sizes, in fascicles separated by stroma, which reacted firmly and consistently to CD117/c-kit and CD34, and negative to desmin and S-100 protein. There was weak staining for nuclear Ki-67 in the tumor cells. A diagnosis of rectal gastrointestinal stromal tumor was confirmed. After a multidisciplinary meeting, an abdominoperineal resection of his rectum was performed. The pathology of the specimen confirmed the diagnosis of rectal gastrointestinal stromal tumor. He is now asymptomatic after 3 months' follow-up and is on adjuvant therapy with a tyrosine-kinase inhibitor. Gastrointestinal stromal tumors are rare tumors, and among the variety of primary location sites, the rectum is one of the rarest. The localization of this type of tumor has worse outcomes and higher morbidity rates. We report this rare case to emphasize the need for precise diagnosis and the important role of endoscopic ultrasound-guided fine needle aspiration in such situations.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 17 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 17 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 3 18%
Other 2 12%
Student > Master 2 12%
Student > Postgraduate 2 12%
Student > Ph. D. Student 2 12%
Other 4 24%
Unknown 2 12%
Readers by discipline Count As %
Medicine and Dentistry 8 47%
Computer Science 3 18%
Agricultural and Biological Sciences 2 12%
Pharmacology, Toxicology and Pharmaceutical Science 1 6%
Biochemistry, Genetics and Molecular Biology 1 6%
Other 0 0%
Unknown 2 12%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 March 2017.
All research outputs
#18,536,772
of 22,958,253 outputs
Outputs from Journal of Medical Case Reports
#2,274
of 3,938 outputs
Outputs of similar age
#237,292
of 310,354 outputs
Outputs of similar age from Journal of Medical Case Reports
#51
of 98 outputs
Altmetric has tracked 22,958,253 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 3,938 research outputs from this source. They receive a mean Attention Score of 4.0. This one is in the 11th percentile – i.e., 11% of its peers scored the same or lower than it.
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We're also able to compare this research output to 98 others from the same source and published within six weeks on either side of this one. This one is in the 2nd percentile – i.e., 2% of its contemporaries scored the same or lower than it.