Incidental Findings of Benign Mesenchymal Tumours during Laparoscopic Gastric Mini Bypass Surgery: Two Case Reports

Primary benign gastrointestinal mesenchymal tumours are rare neoplasms [1,2]. The non-exhaustive list includes GIST, leiomyoma, desmoids tumour, inflammatory myofibroblastic tumour, inflammatory fibroid polyp, Schwannoma, lymphoma, mesenchymal polyps and glomus tumour. These tumours frequently show similar and overlapping morphology. However the cell of origin is different in different entities ranging from smooth muscle, nerve sheath and fibroblasts to cell of CAJAL. Consequently immunohistochemistry is often needed to reach the correct final diagnosis. Since the Bariatric surgery is now one of the common procedures done at most of the centres, rate of incidental findings of the primary benign mesenchymal tumours in sleeve gastrectomy is about 0.3% [3,4]. However we are presenting here two cases of patients undergoing Gastric Mini Bypass procedure which does not result in a pathology specimen. In the first case a small part of stomach was trimmed while making it suitable size for anastomosis. The trimming was sent to our department by default without any suspicion. We during gross examination found a small mass on serosal surface which was later diagnosed as benign GIST [5]. In second case the surgeon recognised two small masses during the procedure, excised them and sent to us. One turned out to be Leiomyoma and the other was a reactive lymph node.