Introduction/Background The rectovaginal septum is a rare location for gastrointestinal stromal tumors (GIST) to occur. The aim of this study is presentation of a patient with solitary liver metastasis and local recurrence from low-risk extra gastrointestinal tumor (e-GIST) in rectovaginal space.

Methodology A 55-year-old woman with a medical history of operated meningiomas, was referred to our department for a 5 cm solitary liver metastasis e-Gist, in the segments II/III. The patient had undergone transvaginal resection of a low-risk e-GIST metastasis 6 months ago for which she did not receive additional chemotherapy. On clinical examination, an image compatible with local recurrence in the posterior wall of the vagina and imaging examination did not reveal any radiologic findings. The patient underwent a synchronous resection with laparoscopic left lateral hepatectomy and transvaginal resection and reconstruction with posterior colporraphy. Her postoperative course was uneventful and was discharged on postoperative day 5.

Results Histological examination revealed for liver tumor high risk GIST with CKIT (+), DOG1 (+), ki67≥ 30%, high mitotic activity, R0 resection. The histological examination of the vaginal lesson revealed the development of neoplasm with the same characteristics with the initial histology expect from the mitotic index, which was >20%. The patient was referred for adjuvant chemotherapy.

Conclusion E-GISTs are rare neoplasms, with generally low malignancy potential. However, these tumors can have metastatic potential and require aggressive treatment.

Disclosures All authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this case report.