Jejunal gastrointestinal stromal tumors mimicking arteriovenous malformation: A review of the literature

Abstract

Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms that may arise anywhere along the gastrointestinal tract. While most GISTs remain asymptomatic, presentation with acute, massive gastrointestinal hemorrhage is uncommon. An even rarer diagnostic challenge occurs when these tumors radiologically mimic arteriovenous malformations (AVMs). We describe a 45-year-old male who presented with life-threatening gastrointestinal bleeding and congestive cardiac failure secondary to profound anemia (hemoglobin 2.9 g/dL). Contrast-enhanced computed tomography angiography demonstrated a hypervascular jejunal lesion with early venous drainage, suggestive of an AVM. The patient underwent laparoscopy-assisted segmental jejunal resection with primary anastomosis. Histopathological examination confirmed a jejunal GIST without evidence of an arteriovenous malformation. Complete excision was achieved, and the patient recovered uneventfully. GISTs should be considered an important differential diagnosis in patients presenting with acute, massive gastrointestinal bleeding. Awareness that hypervascular GISTs may closely resemble AVMs on cross-sectional imaging is essential to ensure accurate diagnosis and timely management.