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Liu J, Huang BJ, Ding FF, Tang FT, Li YM. Synchronous occurrence of gastric cancer and gastrointestinal stromal tumor: A case report and review of the literature. World J Gastrointest Oncol 2023; 15:1807-1822. [PMID: 37969409 PMCID: PMC10631440 DOI: 10.4251/wjgo.v15.i10.1807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/20/2023] [Accepted: 09/14/2023] [Indexed: 10/10/2023] Open
Abstract
BACKGROUND To evaluate the clinicopathological features and prognosis of gastric cancer (GC) occurring synchronously with gastrointestinal stromal tumor (GIST). CASE SUMMARY We report 19 patients with concurrent GC and GIST (17 male and 2 female, median age 62 years). GC was most often located in the lower third of the stomach. GIST was diagnosed preoperatively in four patients. GIST was most often located in the gastric body (n = 8, 42%). The most common growth pattern in GIST was extraluminal (n = 12, 63%). The positive expression rates of CD117 and CD34 in GIST were 100% and 95%, respectively. Most patients with GIST (n = 17, 89%) were very low or low risk. There was no recurrence of GIST during follow-up. The 3-year cumulative survival rate was 73.9%, and the 5-year cumulative survival rate was 59.2%. The combined analysis of this study and literature reports (47 reports, 157 patients) found that GC and GIST were usually located in the lower third (42%) and middle third (51%) of the stomach. GC was usually early (stage I: 42%), poorly differentiated (42%) intestinal-type adenocarcinoma (51%). GISTs were primarily small in diameter (median: 1.2 cm) and very low or low risk (89%). CONCLUSION Synchronous GC and GIST may not be rare. They have specific clinicopathological characteristics, and may have mutual inhibition in pathogenesis and progression.
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Affiliation(s)
- Jie Liu
- Department of General Surgery, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China
- Key Laboratory of the Digestive System Tumors of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China
| | - Bin-Jie Huang
- Department of General Surgery, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China
- Key Laboratory of the Digestive System Tumors of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China
| | - Fei-Fei Ding
- Department of General Surgery, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China
- Key Laboratory of the Digestive System Tumors of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China
| | - Fu-Tian Tang
- Department of General Surgery, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China
- Key Laboratory of the Digestive System Tumors of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China
| | - Yu-Min Li
- Department of General Surgery, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China
- Key Laboratory of the Digestive System Tumors of Gansu Province, Lanzhou University Second Hospital, Lanzhou 730030, Gansu Province, China
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A/L Chandrasekaran T, Sahid NA, Maiyauen TK. Synchronous Gastrointestinal Stromal Tumor (GIST) with pancreatic adenocarcinoma: A case report. Ann Med Surg (Lond) 2022; 77:103588. [PMID: 35638052 PMCID: PMC9142392 DOI: 10.1016/j.amsu.2022.103588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/01/2022] [Accepted: 04/02/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Gastrointestinal Stromal Tumors (GIST) are rare mesenchymal neoplasm of gastrointestinal tract. Stomach is the most common site affected by GIST compared to other places in gastrointestinal track. The coexistence of GIST with another malignancy represents a rare phenomenon with few literature reported. Case presentation We present here 65 years old patient with stomach GIST and synchronous pancreatic adenocarcionoma discovered during surgery for suspected pancreatic mucinious cystadenoma. Distal pancreaticosplenectomy with excision of GIST Tumor & wedge resection of stomach was done. Histopathological examination of resected specimens reported the margins are clear. Discussion In this article we discuss on the option of systemic therapy versus upfront surgery and their outcome benefit based on literature review. Conclusion The coexistence of GIST with pancreatic adenocarcinoma is a rare condition. High clinical analysis needed during laparotomy for GIST to detect a synchronous tumor. In a case of GIST the surgeon should recognize the possibility of another tumor with different histological origin. Surgical excision is the mainstay of therapy and it has proven to be curative for our patient. . Due to its rare occurrence and limited literature further studies has to be done on GIST with other synchronous tumor to help the surgeon to manage the patient optimally.
A rare presentation of Gastrointestinal Stromal Tumor (GIST) with Pancreatic Adenocarcinoma in a 65 years old gentleman. It is a challenging diagnostic dilemma in patients with dual pathology. There is a need of Intraoperative assessment in patients with GIST tumor to rule out synchronous tumors. It highlight the role of neoadjuvant imatinib versus surgery upfront benefits the prognosis.
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Affiliation(s)
| | - Nik Amin Sahid
- Surgical Department, Faculty of Medicine & Health Sciences, University Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Corresponding author.
| | - Thanesh Kumar Maiyauen
- Surgical Department, Hospital Queen Elizabeth, 13a, Jalan Penampang, 88200, Kota Kinabalu, Sabah, Malaysia
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Diamantis A, Samara AA, Baloyiannis I, Symeonidis D, Diamantis AM, Tolia M, Bouliaris K, Koukoulis G, Tepetes K. Gastrointestinal Stromal Tumor (GIST) and Synchronous Intra-Abdominal Liposarcoma: A Report of Two Rare Cases and Literature Review. Int J Surg Oncol 2021; 2021:2626635. [PMID: 34518784 PMCID: PMC8434899 DOI: 10.1155/2021/2626635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 08/25/2021] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Gastrointestinal stromal tumors (GISTs) quite frequently occur synchronously with other malignancies, with most cases being adenocarcinomas. GISTs and liposarcomas are both of mesenchymal origin, and their coexistence is extremely rare. METHODS We conducted a review of the current literature regarding the synchronous occurrence of GISTs and intra-abdominal liposarcomas. An electronic search of the literature was undertaken using MEDLINE (database provider PubMed). Furthermore, we present the first described case of an 86-year-old male with a GIST and synchronous liposarcoma, both located in the stomach, as well as a 66-year-old male with a gastric GIST and concurrent retroperitoneal liposarcoma. RESULTS A total of 5 cases of synchronous GIST and intra-abdominal liposarcoma have been reported in the literature to date, with the most recent cases included in the present study. CONCLUSION Further research is required to explain any possible correlation in the coexistence of these different neoplasms of the same origin. Meanwhile, R0 resection of both tumors remains the treatment of choice.
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Affiliation(s)
| | - Athina A. Samara
- Department of General Surgery, University Hospital of Larissa, Larissa, Greece
| | - Ioannis Baloyiannis
- Department of General Surgery, University Hospital of Larissa, Larissa, Greece
| | | | | | - Maria Tolia
- Department of Radiotherapy, University of Crete, Heraklion, Greece
| | | | - Georgios Koukoulis
- Department of Pathology, University Hospital of Larissa, Larissa, Greece
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Waidhauser J, Bornemann A, Trepel M, Märkl B. Frequency, localization, and types of gastrointestinal stromal tumor-associated neoplasia. World J Gastroenterol 2019; 25:4261-4277. [PMID: 31435178 PMCID: PMC6700699 DOI: 10.3748/wjg.v25.i30.4261] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 06/22/2019] [Accepted: 07/05/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND In recent years, increasing evidence of second neoplasms associated with gastrointestinal stromal tumors (GIST) has been found. Numerous case reports, mostly retrospective studies and a few reviews, have been published. To our knowledge, however, no systematic review or meta-analysis of the existing data has been performed so far. AIM To prepare a compilation, as complete as possible, of all reported second tumor entities that have been described in association with GIST and to systematically analyze the published studies with regard to frequency, localization, and types of GIST-associated neoplasms. METHODS The MEDLINE and EBSCO databases were searched for a combination of the keywords GIST/secondary, synchronous, coincident/tumor, neoplasm, and relevant publications were selected by two independent authors. RESULTS Initially, 3042 publications were found. After deletion of duplicates, 1631 remained, and 130 papers were selected; 22 of these were original studies with a minimum of 20 patients, and 108 were case reports. In the 22 selected studies, comprising a total number of 12050 patients, an overall rate of GIST-associated neoplasias of 20% could be calculated. Most second neoplasias were found in the gastrointestinal tract (32%) and in the male and female urogenital tract (30%). The specific risk scores of GISTs associated with other tumors were significantly lower than those without associated neoplasias. CONCLUSION In this first systematic review, we could confirm previously reported findings of a more than coincidental association between GIST and other neoplasias. The question whether there is an underlying causal association will need further investigation. Our data suggest that even GIST with a very low risk of disease progression should prompt screening for second neoplasia and subsequent frequent controls or extended staging.
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Affiliation(s)
- Johanna Waidhauser
- Institute of Pathology and Molecular Diagnostics, University Medical Center Augsburg, Augsburg 86156, Germany
- Department of Hematology and Clinical Oncology, University Medical Center Augsburg, Augsburg 86156, Germany
| | - Anne Bornemann
- Institute of Pathology and Molecular Diagnostics, University Medical Center Augsburg, Augsburg 86156, Germany
| | - Martin Trepel
- Department of Hematology and Clinical Oncology, University Medical Center Augsburg, Augsburg 86156, Germany
| | - Bruno Märkl
- Institute of Pathology and Molecular Diagnostics, University Medical Center Augsburg, Augsburg 86156, Germany
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Zhou Y, Wu XD, Shi Q, Xu CH, Jia J. Coexistence of gastric gastrointestinal stromal tumor, intro-abdominal and retroperitoneal liposarcomas -a case report. BMC Cancer 2018; 18:968. [PMID: 30309328 PMCID: PMC6182834 DOI: 10.1186/s12885-018-4886-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 10/01/2018] [Indexed: 12/25/2022] Open
Abstract
Background Gastric gastrointestinal stromal tumor (GIST), intro-abdominal and retroperitoneal neoplasms are distinct tumors arising from different cell layers; therefore, coexistence of such tumors is relatively rare. Case presentation A man complained of early satiety for 2 mouths, whose upper gastrointestinal (GI) endoscopy showed a tumor arising from the greater curvature of gastric body and extending into the lumen. Abdominal computed tomography (CT) revealed coexistence of gastric, intro-abdominal and retroperitoneal masses. Wedge resection for gastric tumor, resection for intro-abdominal and retroperitoneal tumors were done. The postoperative histological examination suggested simultaneous development of a gastric GIST, intro-abdominal and retroperitoneal myxoid liposarcomas. Conclusion Although both GISTs and liposarcomas originate from mesenchymal tissues, simultaneous development of a gastric GIST, intro-abdominal and retroperitoneal liposarcomas is the first such case to be reported in the literature.
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Affiliation(s)
- Yong Zhou
- Department of General surgery, Yancheng City No.1 people's hospital, Yancheng, Jiangsu Province, 224005, China
| | - Xu-Dong Wu
- Department of Gastroenterology, Yancheng City No.1 people's hospital, 16 Yuehe Road, Yancheng, Jiangsu Province, 224005, China.
| | - Quan Shi
- Department of Radiology, Yancheng City No.1 people's hospital, Yancheng, Jiangsu Province, 224005, China
| | - Chuan-Hai Xu
- Department of Pathology, Yancheng City No.1 people's hospital, Yancheng, Jiangsu Province, 224005, China
| | - Jing Jia
- Department of Nephrology, Yancheng City No.1 people's hospital, Yancheng, Jiangsu Province, 224005, China
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Jiang MJ, Weng SS, Cao Y, Li XF, Wang LH, Xu JH, Yuan Y. Metachronous Primary Adenocarcinoma of Lung During Adjuvant Imatinib Mesylate Therapy for Gastrointestinal Stromal Tumor of Stomach: A Case Report. Medicine (Baltimore) 2015; 94:e1484. [PMID: 26356712 PMCID: PMC4616658 DOI: 10.1097/md.0000000000001484] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor in gastrointestinal tracts; however, the synchronous or metachronous coexistence of GIST with additional primary malignancy is not common.Here, we present an unusual case of gastric GIST with metachronous primary lung adenocarcinoma diagnosed during his adjuvant treatment with oral receptor tyrosine kinase inhibitor imatinib mesylate (400 mg daily). After 6-month use of imatinib, the patient suffered from dry cough and dyspnea. Subsequent lung biopsy demonstrated adenocarcinoma with diffuse interstitial changes.Our research emphasizes the possibility of an additional primary tumor with GIST, and reminds the clinicians to strengthen the surveillance of the additional cancer during the follow-up of GIST patients.
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Affiliation(s)
- Meng-Jie Jiang
- From the Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (M-JJ, S-SW, YC, X-FL, YY); Cancer Institute (Key Laboratory of Cancer Prevention and Intervention, Chinese National Ministry of Education; Key Laboratory of Molecular Biology in Medical Sciences) Zhejiang Province (M-JJ, YC, X-FL, YY); Department of Radiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (L-HW); and Department of Pathology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou (J-HX)
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Reda EOM, Ahmed J, Abderrahim EK, Kawtar Z, Fouad Z, Zakia B, Najat M. Acute intestinal obstruction revealing synchronous gastrointestinal stromal tumors in a small bowel diverticulum and mucinous adenocarcinoma of the colon: a case report. Pan Afr Med J 2015; 21:172. [PMID: 27053978 PMCID: PMC4802801 DOI: 10.11604/pamj.2015.21.172.2828] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2013] [Accepted: 05/26/2015] [Indexed: 11/11/2022] Open
Abstract
Gastrointestinalstromal tumors are rare neoplasms and represent 0,1% to 3% of all gastrointestinal cancers. They are the most frequent mesenchymal neoplasms of the gastrointestinal tract with a malignant potential and unpredictable behavior. The synchronous association with other primary gastrointestinal carcinoma has been rarely reported in the literature with increasing number in the last ten years. The associated Gastrointestinalstromal tumor is usually discovered incidentally during surgery for carcinoma. The limited number of these cases cannot confirm the existence of a common factor in tumorigenesis of these different tumors and other studies are needed to clarify the possible association. We report the first case in the literature of synchronous primary Gastrointestinalstromal tumors developed in small bowel diverticulum and mucinous adenocarcinoma of the colon. Key words: Synchronous, Gastrointestinalstromal tumors, Adenocarcinoma, Colon.
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Affiliation(s)
| | - Jahid Ahmed
- Department of Pathology, Ibn Sina University Hospital, Rabat, Morocco
| | | | - Znati Kawtar
- Department of Pathology, Ibn Sina University Hospital, Rabat, Morocco
| | - Zouaidia Fouad
- Department of Pathology, Ibn Sina University Hospital, Rabat, Morocco
| | - Bernoussi Zakia
- Department of Pathology, Ibn Sina University Hospital, Rabat, Morocco
| | - Mahassini Najat
- Department of Pathology, Ibn Sina University Hospital, Rabat, Morocco
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Zhou Y, Wu XD, Fan RG, Zha WZ, Xu YH, Qing CL, Jia J. Rectal gastrointestinal stromal tumor as an incidental finding in a patient with rectal polyps. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2015; 8:5934-7. [PMID: 26191322 PMCID: PMC4503193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 04/24/2015] [Indexed: 06/04/2023]
Abstract
A patient who was diagnosed as rectal polyps in the local hospital went to our hospital for surgical treatment. Abdominal CT demonstrated a large irregular extra-luminal tumor of at least 5 cm cross-section on the ventral side of the lower rectal wall. Intraoperatively, a large irregular extra-luminal tumor (about 5×4.5×4 cm) was found. Anterior resection with end colostomy and rectal stump (Hartmann's procedure) was performed. Postoperative histological examination showed simultaneous development of rectal GIST and polyps.
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Affiliation(s)
- Yong Zhou
- Department of General Surgery, Yancheng City First People’s HospitalYancheng 224005, China
| | - Xu-Dong Wu
- Department of Gastroenterology, Yancheng City First People’s HospitalYancheng 224005, China
| | - Ren-Gen Fan
- Department of General Surgery, Yancheng City First People’s HospitalYancheng 224005, China
| | - Wen-Zhang Zha
- Department of General Surgery, Yancheng City First People’s HospitalYancheng 224005, China
| | - Yong-Hua Xu
- Department of General Surgery, Yancheng City First People’s HospitalYancheng 224005, China
| | - Cheng-Lin Qing
- Department of General Surgery, Yancheng City First People’s HospitalYancheng 224005, China
| | - Jing Jia
- Department of Nephrology, Yancheng City First People’s HospitalYancheng 224005, China
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Zhou Y, Wu XD, Shi Q, Jia J. Coexistence of gastrointestinal stromal tumor, esophageal and gastric cardia carcinomas. World J Gastroenterol 2013; 19:2005-2008. [PMID: 23569349 PMCID: PMC3613119 DOI: 10.3748/wjg.v19.i12.2005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 12/27/2012] [Accepted: 01/13/2013] [Indexed: 02/06/2023] Open
Abstract
Gastric gastrointestinal stromal tumor (GIST), esophageal squamous cell carcinoma and gastric cardia adenocarcinoma are distinct neoplasms originating from different cell layers; therefore, simultaneous development of such carcinomas is relatively rare. Auxiliary examinations revealed coexistence of esophageal and gastric cardia carcinoma with lymph node metastasis in a 77-year-old man. Intraoperatively, an extraluminal tumor (about 6.0 cm × 5.0 cm × 6.0 cm) at the posterior wall of the gastric body, a tumor (about 2.5 cm × 2.0 cm) in the lower esophagus, and an infiltrative and stenosing tumor (about 1.0 cm × 2.0 cm) in the gastric cardia were detected. Wedge resection for extraluminal gastric tumor, radical esophagectomy for lower esophageal tumor, and cardiac resection with gastroesophageal (supra-aortic arch anastomoses) were performed. Postoperative histological examination showed synchronous occurrence of gastric GIST, esophageal squamous cell carcinoma, and gastric cardia adenocarcinoma. Furthermore, immunohistochemistry indicated strong staining for c-Kit/CD117, Dog-1, Ki-67 and smooth muscle, while expression of S-100 and CD34 was negative.
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Shin DW, Kim H, Kim H, Kwon MH, Kim SD, Bae SH, Kwon JC, Rhee JA, Han MH. Synchronous, Orthotopic Occurrence of Early Gastric Cancer with Gastrointestinal Stromal Tumor that Mimicked Advanced Gastric Cancer. THE KOREAN JOURNAL OF HELICOBACTER AND UPPER GASTROINTESTINAL RESEARCH 2013. [DOI: 10.7704/kjhugr.2013.13.3.182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Dong Woo Shin
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Hyunsoo Kim
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Hyunji Kim
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Moon Hyuk Kwon
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Sang Dong Kim
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Soo Hyun Bae
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Jae Choon Kwon
- Division of Gastroenterology, Department of Internal Medicine, Daegu Fatima Hospital, Daegu, Korea
| | - Jung-Ahn Rhee
- Department of General Surgery, Daegu Fatima Hospital, Daegu, Korea
| | - Man Hoon Han
- Department of Pathology, Daegu Fatima Hospital, Daegu, Korea
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Khoshnevis J, Rakhshan A, Sobhiyeh MR, Gholizadeh B, Rahbari A, Adhami F, Lotfollahzadeh S. Simultaneous gastric adenocarcinoma and gastrointestinal stromal tumor of the stomach: a case report. IRANIAN JOURNAL OF CANCER PREVENTION 2013; 6:55-8. [PMID: 25250111 PMCID: PMC4142907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2012] [Accepted: 11/25/2012] [Indexed: 11/25/2022]
Abstract
Simultaneous a collision tumor of stomach consisting of adenocarcinoma and Gastrointestinal Stromal Tumor (GIST) is very rare based on our knowledge. This coexistence has rarely been reported in literatures. We report a case of 64-year-old woman who has diagnosed with prepyloric poorly-differentiated diffuse signet-ring cell type adenocarcinoma and has undergone an elective D2 total gastrectomy. During operation another mass in fundic body region has found. The pathologic examination of the mass has shown GIST. Immunohistochemical staining for CD117 and Desmin was positive whilst that for S100 was negative. This case reports the simultaneous two tumors development of different histotypes and natures in the same organ.
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Affiliation(s)
- Jalaluddin Khoshnevis
- Dept. of General and Vascular Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Rakhshan
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Sobhiyeh
- Dept. of General and Vascular Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Corresponding Author:
Mohammad Reza Sobhiyeh, MD
Tel: (+98) 21 22 72 11 44
| | - Barmak Gholizadeh
- Dept. of General and Vascular Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Rahbari
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farideh Adhami
- Dept. of General and Vascular Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saran Lotfollahzadeh
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Tan CB, Zhi W, Shahzad G, Mustacchia P. Gastrointestinal stromal tumors: a review of case reports, diagnosis, treatment, and future directions. ISRN GASTROENTEROLOGY 2012; 2012:595968. [PMID: 22577569 PMCID: PMC3332214 DOI: 10.5402/2012/595968] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Accepted: 02/05/2012] [Indexed: 12/13/2022]
Abstract
Gastrointestinal stromal tumor (GIST) is a nonepithelial, mesenchymal tumor first described by Mazur and Clark in 1983. Since then, its molecular biology has been studied in great detail. Special interest in the role of tyrosine kinase in its regulation has been the target by different drug research. Mutation in c-kit exons 9, 11, 13, 17 and PDGFRA mutation in exons 12, 14, 18 are responsible for activation of gene signaling system resulting in uncontrolled phosphorylation and tissue growth. However, 5 to 15% of GISTs does not harbor these mutations, which raises additional questions in another alternate signaling pathway mutation yet to be discovered. Diagnosis of GISTs relies heavily on KIT/CD117 immunohistochemical staining, which can detect most GISTs except for a few 3% to 5% that harbors PDGFRA mutation. Newer staining against PKC theta and DOG-1 genes showed promising results but are not readily available. Clinical manifestation of GISTs is broad and highly dependent on tumor size. Surgery still remains the first-line treatment for GISTs. The advancement of molecular biology has revolutionized the availability of newer drugs, Imatinib and Sunitinib. Together with its advancement is the occurrence of Imatinib/Sunitinib drug resistance. With this, newer monoclonal antibody drugs are being developed and are undergoing clinical trials to hopefully improve survival in patients with GISTs.
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Affiliation(s)
- Christopher B Tan
- Department of Internal Medicine, Nassau University Medical Center, East Meadow, NY 11554, USA
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