Laparoscopic Wedge Resection of a 6 cm Gastrointestinal Stromal Tumor (GIST) Arising From the Lesser Curvature - A Case Report From Jordan

Sep 28, 2026

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Laparoscopic wedge resection of gastrointestinal stromal tumors (GISTs) is preferred for small tumors. This case report evaluates feasibility of laparoscopic resection of a 6 cm GIST arising from the lesser curvature in an elderly patient to avoid major gastrectomy. A 75-year-old, diabetic and hypertensive woman with epigastric pain and vomiting had a 6 cm gastric mass on imaging and endoscopic ultrasound-guided biopsy. After intolerance to neoadjuvant imatinib, the team proceeded with laparoscopic wedge resection, achieving successful recovery, negative postoperative leakage assessment, early discharge, and symptom-free three-month follow-up.

LanguageEnglish

CategoryHealthcare

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Pages10

Reading Time25 min

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Abstract

Introduction

Epidemiology and tumor biology

Diagnosis

Treatment and surgical considerations

Review began 11/09/2025 Review ended 11/19/2025 Published 11/30/2025 © Copyright 2025 Hassanat et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CCBY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited. DOI: 10.7759/cureus.98148 Open Access Case Report Laparoscopic Wedge Resection of a 6 cm Gastrointestinal Stromal Tumor (GIST) Arising From the Lesser Curvature: A Case Report From Jordan Ramadan Hassanat 1, Mohammad Alhroot 1, Qutaiba Qatawneh 2, Eyad Rawashdeh 1, Alhareth Qatawneh Rami Al-Omoor 1, Mutaz Haddadin 1 , Mohammad Al-huniti 1, Omar Abu Zeitoun 1 , Ghidaa Maswadah 1 3 , 1. Department of General Surgery, Jordanian Royal Medical Services, Amman, JOR 2. Department of Radiology, Jordanian Royal Medical Services, Amman, JOR 3. Department of Anesthesiology, Jordanian Royal Medical Services, Amman, JOR Corresponding author: Ramadan Hassanat, [ramadanhasanat@yahoo.com](ramadanhasanat@yahoo.com) Abstract Laparoscopic wedge resection of gastrointestinal stromal tumors (GISTs) is the preferred approach for small-sized tumors. Our case study aims to clarify the feasibility of laparoscopic resection of a 6 cm GIST from the lesser curvature in elderly patients, thereby avoiding major gastrectomy. We present a 75-year-old female patient, diabetic and hypertensive, from Amman, Jordan, who had been suffering from epigastric pain and vomiting for a duration of three months. The computed tomography (CT) scan and endoscopy revealed a 6 cm gastric mass arising from the lesser curvature, 4 cm away from the gastroesophageal junction (GEJ), confirmed by endoscopic ultrasound-guided biopsy as a GIST. The patient was referred to a hematologist for possible mass regression with neoadjuvant imatinib. She was then returned to the surgical team after developing drug intolerance, which exacerbated vomiting. The decision was made for laparoscopic resection based on her clinical scenario, and after full preoperative preparation, the procedure was performed in June 2025 at King Hussein Medical Center. The patient underwent full laboratory and radiological investigations before surgery. She also underwent an endoscopy for mass localization. The procedure was performed successfully through a laparoscopic approach via wedge resection using an endo gastrointestinal anastomosis (GIA) stapler over a 40 F (French) Bougie, followed by a negative methylene blue test. After surgery, the patient was monitored in the general ward and was found to be well. A Gastrografin study was performed to assess the gastric anatomy after resection and to rule out leakage. The patient was discharged on the first postoperative day after tolerating oral intake and was followed up as an outpatient for three months without significant complaints. Categories: Gastroenterology Keywords: case report, gastrointestinal stromal tumor, jordan, laparoscopy, wedge resection Introduction Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal system; they arise from the cells of Cajal in the mesenchymal smooth muscle layer. Most tumors express mutations in KIT CD117 or platelet-derived growth factor receptor alpha (PDGFRA) genes [1] . More than 60% of tumors arise from the stomach, mainly along the greater curvature and the body, and are less commonly found on the lesser curvature, where surgery can be more challenging due to proximity to the gastroesophageal junction (GEJ) and the vagus nerve [1] . In contrast, GISTs arising on the lesser curvature are uncommon and pose specific surgical challenges due to the limited working space, proximity to major vascular structures, and risk of compromising the GEJ [2] . The malignant behavior of the disease is variable according to the site, size, and mitotic index. Usually, the good prognostic factors are gastr

FAQs

Why was laparoscopic wedge resection considered in this case?

Laparoscopic wedge resection is typically preferred for smaller GISTs, and the report aimed to clarify its feasibility for a 6 cm tumor on the lesser curvature while avoiding major gastrectomy.

How was the diagnosis of GIST confirmed?

A CT scan and endoscopy identified the gastric mass, and endoscopic ultrasound-guided biopsy confirmed it as a GIST.

What happened after surgery and during follow-up?

The procedure was completed laparoscopically with successful postoperative monitoring. Leakage was assessed using a Gastrografin study, the patient tolerated oral intake and was discharged on postoperative day one, and follow-up for three months showed no significant complaints.

Sep 28, 2026

Uploaded by Ben