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Objective:The aim of the study was to report an anemia patient with melena for five years caused by duodenal gastrointestinal strornal tumor (GIST),who required surgical treatment.Methods:A 44-year old man present with anemia appearance was admitted to our center (Department of Hepatobiliary Surgery,Union Hospital,Huazhong University of Science and Technology,China) due to sustaining melena for five years.Endoscopy found no special mucosal abnormalities in the duodenal lumen.Computed Tomography showed a well-demarcated mass,7.4 cm in diameter,located between the C loop of duodenum and pancreatic head.Pylorus-preserving pancreaticoduodenectomy and right hemicolectomy were performed when the patient's general conditions were improved.He recuperated successfully and was discharged on the 21 st postoperative day.No complications happened during the period of hospital stay.Results:Histological and immunohistochemical study revealed a high risk invasive duodenal GIST which was positive for CD117,CD34,α-smooth muscle actin and negative for S-100.Conclusion:Duodenal GIST can be a source of upper gastrointestinal hemorrhage;surgical treatment is still a reasonable choice for the patients with invasive duodenal GIST.