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Tao Z, Wu S, Chen Z, Qiu Y, Song L, Yang Q, Nong L, Kang L. A rectal gastrointestinal stromal tumor case accompanied by elevated CEA mimicking rectal carcinoma on 18F-FDG PET/CT. AMERICAN JOURNAL OF NUCLEAR MEDICINE AND MOLECULAR IMAGING 2023; 13:26-32. [PMID: 36923597 PMCID: PMC10009467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 02/14/2023] [Indexed: 03/18/2023]
Abstract
Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasm arising from gastrointestinal tract and can be benign or malignant. Rectal GISTs are rare and have poor prognosis. We here reported an older male who presented with features of distending discomfort in the rectum and pain in the anus due to a large rectal tumor. Physical examinations detected a mass in the rectum without blood staining on the gloved finger. Carcinoembryonic antigen (CEA) was found to be slightly elevated and the prostate-specific antigen level was normal. 18F-FDG PET/CT showed a soft tissue density mass at the bottom of the pelvic, with an unclear boundary to the surroundings with the significantly increased FDG uptake (SUVmax 17.5). Although a rectal carcinoma was suspected based on the finding of PET/CT and CEA, the histopathological examination confirmed the diagnosis of the malignant GIST of the rectum. The patient was then treated with imatinib and on follow-up regularly. In this case, 18F-FDG PET/CT shows the advantage of visualizing both primary and metastatic lesions and provides valuable information for the diagnosis, staging, evaluation, and prognosis of GIST.
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Affiliation(s)
- Zihao Tao
- Department of Nuclear Medicine, Peking University First Hospital Beijing 100034, PR China
| | - Sitong Wu
- Department of Nuclear Medicine, Peking University First Hospital Beijing 100034, PR China
| | - Zhao Chen
- Department of Nuclear Medicine, Peking University First Hospital Beijing 100034, PR China
| | - Yongkang Qiu
- Department of Nuclear Medicine, Peking University First Hospital Beijing 100034, PR China
| | - Lele Song
- Department of Nuclear Medicine, Peking University First Hospital Beijing 100034, PR China
| | - Qi Yang
- Department of Nuclear Medicine, Peking University First Hospital Beijing 100034, PR China
| | - Lin Nong
- Department of Pathology, Peking University First Hospital Beijing 100034, PR China
| | - Lei Kang
- Department of Nuclear Medicine, Peking University First Hospital Beijing 100034, PR China
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Yang J, Yan J, Zeng M, Wan W, Liu T, Xiao JR. Bone Metastases of Gastrointestinal Stromal Tumor: A Review of Published Literature. Cancer Manag Res 2020; 12:1411-1417. [PMID: 32161493 PMCID: PMC7049741 DOI: 10.2147/cmar.s232936] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Accepted: 01/20/2020] [Indexed: 12/23/2022] Open
Abstract
Background With the occurrence and improvement of immunohistochemistry and other pathological diagnostic techniques, gastrointestinal stromal tumor (GIST) has been gradually recognized. With the prolonged survival of patients with GISTs, reports about the bone metastasis of GIST increased. However, the knowledge of GISTs is rather limited due to its very low incidence. Methods Cochrane and Medline database (via PubMed) were searched in July 2019 with related keywords to acquire the literature related to the bone metastasis of GIST. Then, the literature was reviewed and references were also scanned to identify the possible related reports. Study data comprising age, sex, primary location, metastasis interval time, immunohistochemistry index, management and prognosis were recorded and analyzed. Results Forty-five patients with bone metastases of GIST, with a mean age of 61.09 years, were included. The small intestine and stomach were the most common primary sites, followed by the rectum. Patients with small intestine primary sites had bone metastases that occurred earlier than the bone metastases stomach and rectum primary sites. The spine was the most common site of bony metastases. The mean survival time after GIST diagnosis was more than 64.02 months. Patients younger than 60 years old had a worse prognosis than those older than 60 years old. Furthermore, patients with spinal involvement had a worse prognosis than those without spinal involvement. Surgical interventions combined with targeted therapies guaranteed a better prognosis. Conclusion Bone metastasis of GIST, which mainly occurs in the spine, is rather rare. Patients with GISTs of the small intestine and stomach suffered from bone metastasis more frequently and earlier than patients with GISTs in other primary sites. Age, sex, primary tumor location, treatment mode for the primary lesions and metastases, and spine involvement may be potential factors that affect the prognosis of GIST patients with bone metastases.
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Affiliation(s)
- Jian Yang
- Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China
| | - Jijie Yan
- Ningbo University, Ningbo, Zhejiang, People's Republic of China
| | - Meihui Zeng
- Department of Neurosurgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, People's Republic of China
| | - Wei Wan
- Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China
| | - Tielong Liu
- Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China
| | - Jian-Ru Xiao
- Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai, People's Republic of China
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Katayanagi S, Yokoyama T, Makuuchi Y, Osakabe H, Iwamoto H, Sumi T, Hirano H, Katsumata K, Tsuchida A, Hirota S, Kawachi S. Long-Term Survival After Multidisciplinary Treatment Including Surgery for Metachronous Metastases of Small Intestinal Gastrointestinal Stromal Tumors after Curative Resection: A Case Report. AMERICAN JOURNAL OF CASE REPORTS 2019; 20:1942-1948. [PMID: 31875847 PMCID: PMC6944036 DOI: 10.12659/ajcr.918606] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Patient: Male, 56-year-old Final Diagnosis: Metachronous metastases of small intestinal gastrointestinal stromal tumors Symptoms: Abdominal and/or epigastric pain Medication: — Clinical Procedure: Operation • chemotharapy Specialty: Gastroenterology and Hepatology
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Affiliation(s)
- So Katayanagi
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Takayoshi Yokoyama
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Yousuke Makuuchi
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Hiroaki Osakabe
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Hitoshi Iwamoto
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Tetsuo Sumi
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Hiroshi Hirano
- Department of Pathology, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
| | - Kenji Katsumata
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Akihiko Tsuchida
- Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan
| | - Seiichi Hirota
- Department of Surgical Pathology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
| | - Shigeyuki Kawachi
- Department of Digestive and Transplantation Surgery, Tokyo Medical University Hachioji Medical Center, Tokyo, Japan
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Saraireh H, Tayyem O, Al Asad O, Nawgiri R, Alawin I. A Rare Case of a Metastatic Gastrointestinal Stromal Tumor (GIST): a Case Report and Review of the Literature. J Gastrointest Cancer 2017; 50:926-934. [PMID: 29218655 DOI: 10.1007/s12029-017-0037-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Hamzeh Saraireh
- Department of Internal Medicine, University of Texas Medical Branch at Galveston, Galveston, USA.
| | - Obada Tayyem
- Department of Internal Medicine, University of Texas Medical Branch at Galveston, Galveston, USA
| | - Omar Al Asad
- Department of Internal Medicine, Yale New Haven Hospital, New Haven, USA
| | - Ranjana Nawgiri
- Division of Cytopathology, Department of Pathology, University of Texas Medical Branch at Galveston, Galveston, USA
| | - Issam Alawin
- Division of Hematology and Oncology, Department of Internal Medicine, University of Texas Medical Branch at Galveston, Galveston, USA
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Kosemehmetoglu K, Kaygusuz G, Fritchie K, Aydin O, Yapicier O, Coskun O, Karatayli E, Boyacigil S, Guler G, Dervisoglu S, Kuzu I. Clinical and pathological characteristics of gastrointestinal stromal tumor (GIST) metastatic to bone. Virchows Arch 2017; 471:77-90. [PMID: 28488171 DOI: 10.1007/s00428-017-2138-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 03/11/2017] [Accepted: 04/26/2017] [Indexed: 12/16/2022]
Abstract
Our aim in this study was to describe the clinical, morphological, and molecular profile of gastrointestinal stromal tumor (GIST) metastatic to bone. We analyzed the morphological, phenotypic, and molecular characteristics of seven cases, and in addition reviewed 17 cases from literature. Sequence analysis of KIT and PDGFRA genes was possible for six cases. For the GIST cases with bone metastasis, the most common primaries were small intestine (29%), stomach (25%), and rectum (21%). Sites of bone metastases were vertebrae (11), pelvis (8), femur (8), ribs (6), humerus (5), skull (3), scapula (1), and mandible (1). The size ranged from 1.5 to 13 cm (median, 3.8 cm). Bone metastases without involvement of any other organ were seen in 17% of the cases and were solitary in 14 (58%). Adjacent soft tissue involvement was present in nearly half of the patients. Bone metastasis was either manifest at the time of diagnosis (28%) or occurred after a mean period of 4.7 years (3 months-20 years). Morphologically, neoplastic cells were spindle in 67%, epithelioid in 13%, and mixed epithelioid and spindle in 20%. CD117, DOG1, and CD34 were positive in 88, 86, and 85% of the cases, respectively. KIT Exon 11 mutations were the most frequent gene alteration (78%), followed by KIT Exon 13 mutations. Of 17 of the cases with available follow-up information, 7 (41%) patients developed bone metastasis under imatinib therapy. Five patients (29%) died of disease within a mean of 17 months. Bone metastases from GIST are usually found in patients with advanced disease and typically present as lytic masses with occasional soft tissue involvement. We could not identify any KIT or PDGFRA alterations predisposing to bone metastasis.
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Affiliation(s)
- Kemal Kosemehmetoglu
- Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey.
| | - Gulsah Kaygusuz
- Department of Pathology, Ankara University School of Medicine, Ankara, Turkey
| | - Karen Fritchie
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Ovgu Aydin
- Department of Pathology, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Ozlem Yapicier
- Department of Pathology, Acıbadem University School of Medicine, Istanbul, Turkey
| | - Oznur Coskun
- Department of Pathology, Ankara University School of Medicine, Ankara, Turkey
| | | | - Senay Boyacigil
- Department of Pathology, Ankara University School of Medicine, Ankara, Turkey
| | | | - Sergulen Dervisoglu
- Department of Pathology, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey
| | - Isinsu Kuzu
- Department of Pathology, Ankara University School of Medicine, Ankara, Turkey
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Rochigneux P, Mescam-Mancini L, Perrot D, Bories E, Moureau-Zabotto L, Sarran A, Guiramand J, Bertucci F. Gastrointestinal Stromal Tumour with Synchronous Bone Metastases: A Case Report and Literature Review. Case Rep Oncol 2017; 10:66-76. [PMID: 28203166 PMCID: PMC5301111 DOI: 10.1159/000455188] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 12/19/2016] [Indexed: 12/15/2022] Open
Abstract
Gastrointestinal stromal tumours (GISTs) are mesenchymal tumours of the digestive tract, derived from Cajal interstitial cells. Bone metastases are very rare, and there is no consensus regarding their treatment. Here, we present the unusual case of a 66-year-old man with a gastric GIST with synchronous bone and liver metastases, fully documented at the pathological and molecular levels with a KIT exon 11 mutation. After 9 months of imatinib, the scanner showed a 33% partial response of target lesions. We also review the literature and describe the characteristics, treatment, and outcome of all cases previously reported.
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Affiliation(s)
| | | | - Delphine Perrot
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France
| | - Erwan Bories
- Department of Gastroenterology, Institut Paoli-Calmettes, Marseille, France
| | | | - Anthony Sarran
- Department of Radiology, Institut Paoli-Calmettes, Marseille, France
| | - Jérôme Guiramand
- Department of Surgery, Institut Paoli-Calmettes, Marseille, France
| | - François Bertucci
- Department of Medical Oncology, Institut Paoli-Calmettes, Marseille, France; Aix-Marseille University, Marseille, France
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Nakajima T, Sugiyama T, Baba H, Hatta H, Nishida T, Miwa S, Hayashi S, Tsuneyama K, Imura J. Bone metastasis in gastrointestinal stromal tumors preferentially occurs in patients with original tumors in sites other than the stomach. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:5955-5959. [PMID: 26191327 PMCID: PMC4503198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 04/26/2015] [Indexed: 06/04/2023]
Abstract
Bone metastases are rare in gastrointestinal stromal tumors (GISTs) and data on the clinicopathological profiles are lacking. The purpose of this report was to identify the clinicopathological profiles of this rare clinical setting by evaluating 23 cases, four of which were our own and the additional 19 were from the relevant English literature. In 18 cases, the primary GISTs occurred in sites other than the stomach, although a high proportion of these tumors do arise in the stomach. All tumors at the disease presentation had more than a low risk of recurrence, with most tumors either at a high risk or initially malignant with liver metastasis. In four cases, bone metastasis was the primary metastatic manifestation. Although rare in GISTs, bone metastasis should be considered in patients with primary tumors at a high risk for recurrence or in initially malignant tumors with liver metastasis, especially with primary tumors in sites other than the stomach.
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Affiliation(s)
- Takahiko Nakajima
- Department of Diagnostic Pathology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama2630 Sugitani, Toyama 930-0194, Japan
| | - Toshiro Sugiyama
- Department of Gastroenterology and Hematology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama2630 Sugitani, Toyama 930-0194, Japan
| | - Hayato Baba
- Department of Diagnostic Pathology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama2630 Sugitani, Toyama 930-0194, Japan
| | - Hideki Hatta
- Department of Diagnostic Pathology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama2630 Sugitani, Toyama 930-0194, Japan
| | - Takeshi Nishida
- Department of Diagnostic Pathology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama2630 Sugitani, Toyama 930-0194, Japan
| | - Shigeharu Miwa
- Department of Diagnostic Pathology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama2630 Sugitani, Toyama 930-0194, Japan
| | - Shinichi Hayashi
- Department of Diagnostic Pathology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama2630 Sugitani, Toyama 930-0194, Japan
| | - Koichi Tsuneyama
- Department of Molecular and Environmental Pathology, Institute of Health Biosciences, University of Tokushima Graduate School3-8-15 Kuramotomachi, Tokushima 770-8503, Japan
| | - Johji Imura
- Department of Diagnostic Pathology, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama2630 Sugitani, Toyama 930-0194, Japan
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Suzuki K, Yasuda T, Nagao K, Hori T, Watanabe K, Kanamori M, Kimura T. Bone metastasis of a gastrointestinal stromal tumor: A report of two cases. Oncol Lett 2015; 9:1814-1818. [PMID: 25789048 PMCID: PMC4356394 DOI: 10.3892/ol.2015.2976] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 01/22/2015] [Indexed: 01/07/2023] Open
Abstract
Gastrointestinal stromal tumors (GISTs) are the most frequently diagnosed mesenchymal tumors of the GI tract. GISTs usually arise from the stomach, followed by the small intestine, rectum and other locations in the GI tract. The most common metastatic sites are the liver and peritoneum, whereas GISTs rarely metastasize to the bone. Although a small number of previous studies have described bone metastases originating from GISTs, the true prevalence is yet to be elucidated. The present study describes two cases of bone metastasis in patients with GISTs and reviews the relevant literature. Case one was of a 78-year-old male who presented with bone metastasis to the femoral neck five years after the resection of a GIST. The metastasis was completely resected and the patient remains alive nine years after the initial diagnosis of the GIST. Case 2 was of a 41-year-old male who presented with bone metastases to the ribs following resection of GISTs seven and 17 years earlier. The metastases were completely resected and the patient remains alive 17 years after the initial diagnosis. In total, only 10 cases of GISTs with metastases to the bone have been reported in the English literature. The possibility of bone metastases originating from a GIST should be considered during clinical follow-up, particularly in the presence of liver metastases. If feasible, bone metastases should be completely surgically excised.
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Affiliation(s)
- Kayo Suzuki
- Department of Orthopedic Surgery, University of Toyama, Toyama, Toyama 930-0194, Japan
| | - Taketoshi Yasuda
- Department of Orthopedic Surgery, University of Toyama, Toyama, Toyama 930-0194, Japan
| | - Kaoru Nagao
- Department of Orthopedic Surgery, Iiyama Red Cross Hospital, Iiyama, Nagano 389-2295, Japan
| | - Takeshi Hori
- Department of Orthopedic Surgery, Iiyama Red Cross Hospital, Iiyama, Nagano 389-2295, Japan
| | - Kenta Watanabe
- Department of Orthopedic Surgery, University of Toyama, Toyama, Toyama 930-0194, Japan
| | - Masahiko Kanamori
- Department of Human Science, University of Toyama, Toyama, Toyama 930-0194, Japan
| | - Tomoatsu Kimura
- Department of Orthopedic Surgery, University of Toyama, Toyama, Toyama 930-0194, Japan
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