Mesentric cyst with a twist

With an incidence rate of 0.1-0.3% gastrointestinal stromal tumors (GIST) are rare to be found in extraintestinal locations known as extraintestinal GIST (EGIST). Mesenchymal in origin, they arise from interstitial cells of Cajal, a part of gastrointestinal autonomic nervous system (ANS). It is more common in males than females. GIST is mainly seen in stomach followed by small bowel, colon, rectum and esophagus. Incidence of EGIST is less than 1%. Patients with neurofibromatosis-1 has increased incidence of GIST. It can also present as Carney-Stratakis syndrome. GIST less than 2 cm is usually asymptomatic while GIST more than 2 cm presents with unexplained growth of abdomen, nausea, anemia, difficulty in swallowing, loss of appetite and weight loss. Herein we present a case of 31-yr old female, who presented with complaints of intermittent abdominal pain and was evaluated for infertility. Abdominal ultrasonography (USG) revealed cystic mass of mesentery. Computed tomography (CT) scan abdomen confirmed a cystic lesion with central necrosis arising from jejunal loops. Surgical excision of mesenteric cyst was performed and histopathological diagnosis of gastrointestinal tumor was given. Thus, high index of suspicion is required on part of pathologist to expect an EGIST mimicking as a mesenteric cyst.