A surprise visitor at cesarean section: Gastrointestinal stromal tumor of the uterus

Gastrointestinal stromal tumors (GISTs) are rare mesenchymal tumors that almost always arise from the GI tract and account for 0.1-3% of GI tumors. During pregnancy, GIST is highly unusual given the predilection of this tumor to appear in the fifth to seventh decade of life. The finding of GISTs outside the GI tract is also rare as the cell of origin of these tumors is believed to be the interstitial cell of Cajal, found only in the GI tract. Extra intestinal GISTs have been reported with a few cases arising from the uterus or metastatic to the ovary; however; an asymptomatic uterine GIST occurring at pregnancy as an incidental finding during cesarean section has not been reported so far. We present a 32-year-old lady who underwent an emergency caesarean section and was found to have a GIST of the uterus. The tumor was excised in toto and she started imatinib therapy postoperatively. At the end of three years of close follow-up, she has done well with no evidence of recurrence.