An Infrequent Offender in Hematochezia: Jejunal Gastrointestinal Stromal Tumor

Introduction: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms of the gastrointestinal (GI) tract. They originate from the interstitial cells of Cajal and exhibit the characteristic cytogenetic marker c-Kit, also known as CD117. While often asymptomatic, life-threatening GI bleeding is one of the possible clinical presentations. Diagnosis relies on imaging, endoscopic or cross-sectional, while histology confirms the diagnosis. Surgery is the therapeutic option of choice in non-metastatic resectable GIST, while targeted molecular therapies are recommended for metastatic or nonresectable lesions.
Case Report: Our patient presented with melena and symptomatic anemia with no apparent source of bleeding on initial esophagogastroduodenoscopy (EGD). Abdominal imaging revealed a lobulated vascular mass in the proximal jejunum, which was surgically resected and confirmed to be a low-grade spindle cell type GIST without metastasis. His postoperative course was uneventful, and he remains asymptomatic with no evidence of recurrence on follow-up imaging at 8 months.
Conclusion: This case highlights the importance of a structured diagnostic approach in GI bleeding and provides a brief review of the current literature on GIST. In the current era of advanced endoscopic techniques, GIST remains one of the clinical scenarios in which surgical intervention still holds the upper hand in definitive patient care for GI luminal bleeding.