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Small bowel obstruction: a rare presentation of systemic mastocytosis
  1. Basil Babu1,
  2. Satish Subbiah Nagaraj1,
  3. Vivek Gopalam1 and
  4. Kim Vaiphei2
  1. 1Department of General Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  2. 2Department of Histopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
  1. Correspondence to Dr Basil Babu; drbasilms{at}gmail.com

Abstract

Mastocytosis (MC) is a heterogeneous group of disorders characterised by abnormal growth, neoplastic proliferation and accumulation of mast cells. Approximately, 80% of patients with MC have evidence of skin involvement, while the rest may involve the gastrointestinal tract, liver, spleen or bone. Isolated gastrointestinal presentation of aggressive MC without bone marrow involvement and cutaneous symptoms is rare. Isolated MC with tumour cells infiltrating the ileum presenting with mechanical obstruction has not been reported in the literature to date. Here, we present a case of a patient in his late 50s who presented with malignant MC of the small bowel with obstruction in the emergency surgical outpatient department. The patient underwent surgical resection of the affected bowel. Histopathological examination along with immunohistochemistry revealed malignant MC. The further evaluation consisted of bone marrow biopsies, PET CT and other mutation analyses. However, the patient succumbed to death during the further course of treatment. The differential of MC must be kept in mind when there is the presence of abnormal hematopoietic cells in gastrointestinal biopsies even in the absence of cutaneous manifestations and bone marrow abnormalities.

  • Malignant and Benign haematology
  • Surgical oncology
  • Gastrointestinal surgery
  • Small intestine cancer

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Footnotes

  • Contributors The following authors were responsible for drafting of the text, sourcing and editing of clinical images, investigation results, drawing original diagrams and algorithms, and critical revision for important intellectual content: BB, SSN, KV, VG. The following authors gave final approval of the manuscript: BB, SSN, KV, VG.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.