Abstract
Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms, especially in pediatric patients, often presenting with distinct clinical and molecular characteristics. This case report describes a 12-year-old girl with a large gastric GIST complicated by tumor rupture and hemoperitoneum. Initial treatment with imatinib was followed by emergent surgical intervention due to tumor bleeding. Histopathology confirmed an epithelioid-type GIST, necessitating continued imatinib therapy. Pediatric GISTs demonstrate an indolent but unpredictable course, requiring a multidisciplinary approach. Despite their aggressive nature, pediatric cases show better survival outcomes than adults. This case underscores the importance of timely intervention, individualized therapy, and long-term follow-up to improve prognosis in children with GISTs.