Case Report
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 28, 2015; 21(20): 6404-6408
Published online May 28, 2015. doi: 10.3748/wjg.v21.i20.6404
Gastrointestinal stromal tumor solitary distant recurrence in the left brachialis muscle
Su-Sin Jin, Hyeong-Seok Jeong, Hyun-Jin Noh, Woo-Hyung Choi, Seung-Hwa Choi, Kang-Yeon Won, Dong-Pil Kim, Ji-Chan Park, Mi-Kyong Joung, Jeong-Goo Kim, Hae-Joung Sul, Seung-Woo Lee
Su-Sin Jin, Hyeong-Seok Jeong, Hyun-Jin Noh, Woo-Hyung Choi, Seung-Hwa Choi, Kang-Yeon Won, Dong-Pil Kim, Ji-Chan Park, Seung-Woo Lee, Division of Gastroenterology, Department of Internal Medicine, Daejeon St. Mary’s Hospital, The Catholic University of Korea, Daejeon 301-723, South Korea
Mi-Kyong Joung, Department of Internal Medicine, Anyang Sam Hospital, Anyang 433-730, South Korea
Jeong-Goo Kim, Department of General Surgery, Daejeon St. Mary’s Hospital, The Catholic University of Korea, Daejeon 301-723, South Korea
Hae-Joung Sul, Department of Pathology, Daejeon St. Mary’s Hospital, The Catholic University of Korea, Daejeon 301-723, South Korea
Author contributions: Jin SS designed and wrote the case report; Jeong HS, Noh HJ, Choi WH, Choi SH, Won KY, Kim DP, Park JC, Joung MK and Kim JG revised the report critically for important intellectual content; Sul HJ provided the figures and discussion of the pathology; and Lee SW approved the final version to be published.
Ethics approval: The case report was reviewed and approved by the Daejeon Catholic Medical Center Institutional Review Board.
Informed consent: Informed consent was waived because the patient is deceased.
Conflict-of-interest: There are no potential conflicts of interest for any of the authors.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Seung-Woo Lee, MD, Division of Gastroenterology, Department of Internal Medicine, Daejeon St. Mary’s Hospital, The Catholic University of Korea, 64 Daeheung-ro, Jung-gu, Daejeon 301-723, South Korea. leeseungw00@hanmail.net
Telephone: +82-42-2209501 Fax: +82-42-2526807
Received: December 14, 2014
Peer-review started: December 16, 2014
First decision: January 8, 2015
Revised: February 14, 2015
Accepted: March 27, 2015
Article in press: March 27, 2015
Published online: May 28, 2015
Processing time: 167 Days and 5 Hours
Abstract

Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors of the gastrointestinal tract that are most commonly found in the stomach. Although GISTs can spread to the liver and peritoneum, metastasis to the skeletal muscle is very rare and only four cases have previously been reported. These cases involved concurrent skeletal metastases of primary GISTs or liver metastases. Here, we report the first case of a distant recurrence in the brachialis muscle after complete remission of an extra-luminal gastric GIST following a wedge resection of the stomach, omental excision, and adjuvant imatinib therapy for one year. Ten months after therapy completion, the patient presented with swelling and tenderness in the left arm. Magnetic resonance imaging revealed a large mass in the brachialis muscle, which showed positivity for c-kit and CD34 upon pathologic examination. This is the first reported case of a solitary distant recurrence of a GIST in the muscle after complete remission had been achieved.

Keywords: Brachialis muscle; Distant recurrence; Gastrointestinal stromal tumor; Skeletal metastasis; Tyrosine kinase inhibitor

Core tip: This report presents the first case of the solitary distant recurrence of a gastrointestinal stromal tumor in skeletal muscle after complete remission had been achieved. This case, along with previous reports, indicates that an extended period of tyrosine-kinase inhibitor therapy may reduce metastasis and recurrence in patients with gastrointestinal stromal tumors.