Gastrointestinal Stromal Tumor Presenting Uncommonly as an Intra-lesional Bleed after Antiplatelet Therapy: A Case Report

Background: Gastrointestinal stromal tumors (GISTs) are rare but the most common mesenchymal tumors of the gastrointestinal tract. It has a variable clinical presentation, making early diagnosis difficult. We report a rare case of intra-lesional bleed as the initial presentation of gastric GIST.

Case Presentation: A middle-aged male patient, presented with the diagnosis of ST-elevation Myocardial Infarction. Angioplasty was done and he was kept on multiple blood thinners. Post-procedure, he became unstable and dropped hemoglobin level. Gastroscopy revealed submucosal gastric mass but no source of active bleeding was found. CT angiogram revealed intra-tumoral bleed within the mass. Hence, CT-guided empiric arterial embolization was done before mass would have ruptured. Later, the mass biopsy revealed GIST. Patient was thereafter managed with surgical resection and chemotherapy.

Conclusion: This is an unusual initial presentation of GIST. Life-threatening complications of GIST rupture can be prevented if diagnosed early.