Coexisting and possible primary extra-gastrointestinal stromal tumors of the pancreas and liver: A single case report

Liu,Lei; Zhu,Yingqiao; Wang,Dongxuan; Yang,Changbin; Zhang,Qi; Li,Xiukun; Bai,Yang

doi:10.3892/ol.2016.4420

Coexisting and possible primary extra-gastrointestinal stromal tumors of the pancreas and liver: A single case report

Authors:
- Lei Liu
- Yingqiao Zhu
- Dongxuan Wang
- Changbin Yang
- Qi Zhang
- Xiukun Li
- Yang Bai
View Affiliations

Affiliations: Department of Ultrasound, First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China, Department of Radiation Oncology, The Tumor Hospital of Jilin Province, Changchun, Jilin 130012, P.R. China , Department of Ultrasound, College of Pharmacy, Jilin University, Changchun, Jilin 130012, P.R. China, Ultrasound Department, Jilin Provincial People's Hospital, Changchun, Jilin 130021, P.R. China
Published online on: April 7, 2016 https://doi.org/10.3892/ol.2016.4420
Pages: 3303-3307
Copyright: © Liu et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

Metrics: Total Views: 0 (Spandidos Publications: | PMC Statistics: )

Metrics: Total PDF Downloads: 0 (Spandidos Publications: | PMC Statistics: )

Cited By (CrossRef): 0 citations Loading Articles...

Abstract

Gastrointestinal stromal tumors (GIST) are mesenchymal neoplasms of the gastrointestinal tract (GI) that are defined, in part, by the expression of CD117, a c-Kit proto-oncogene protein. GISTs emerge outside of the GI at a very low frequency, typically in a single organ or location. GISTs that occasionally emerge outside of the GI are classified as extra-gastrointestinal stromal tumors (EGIST). The present study reports an extremely rare case of EGIST detected in the pancreas and the liver. The pancreatic and liver tumors were 4.5x2.5 cm and 2.0x1.5 cm in size, respectively. Both tumors consisted of CD117‑positive spindle cells with a similar mitotic rate of 1‑2 per 50 high power fields. The pancreatic and the hepatic EGISTs were at a low risk of malignancy, and both tumors were proposed to be primary stromal tumors. To the best of our knowledge, this is the first report of likely primary EGIST identified in the pancreas and liver of the same patient.

View Figures

View References

1	Joensuu H, Fletcher C, Dimitrijevic S, Silberman S, Roberts P and Demetri G: Management of malignant gastrointestinal stromal tumours. Lancet Oncol. 3:655–664. 2002. View Article : Google Scholar : PubMed/NCBI
2	Agaimy A and Wünsch PH: Gastrointestinal stromal tumours: A regular origin in the muscularis propria, but an extremely diverse gross presentation. A review of 200 cases to critically re-evaluate the concept of so-called extra-gastrointestinal stromal tumours. Langenbecks Arch Surg. 391:322–329. 2006. View Article : Google Scholar : PubMed/NCBI
3	Hirota S, Isozaki K, Moriyama Y, Hashimoto K, Nishida T, Ishiguro S, Kawano K, Hanada M, Kurata A, Takeda M, et al: Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science. 279:577–580. 1998. View Article : Google Scholar : PubMed/NCBI
4	Sarlomo-Rikala M, Kovatich AJ, Barusevicius A and Miettinen M: CD117: A sensitive marker for gastrointestinal stromal tumors that is more specific than CD34. Mod Pathol. 11:728–734. 1998.PubMed/NCBI
5	Joensuu H, Roberts PJ, Sarlomo-Rikala M, Andersson LC, Tervahartiala P, Tuveson D, Silberman S, Capdeville R, Dimitrijevic S, Druker B and Demetri GD: Effect of the tyrosine kinase inhibitor STI571 in a patient with a metastatic gastrointestinal stromal tumor. N Engl J Med. 344:1052–1056. 2001. View Article : Google Scholar : PubMed/NCBI
6	Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, O'Leary TJ, Remotti H, Rubin BP, et al: Diagnosis of gastrointestinal stromal tumors: A consensus approach. Hum Pathol. 33:459–465. 2002. View Article : Google Scholar : PubMed/NCBI
7	Miettinen M, Monihan JM, Sarlomo-Rikala M, Kovatich AJ, Carr NJ, Emory TS and Sobin LH: Gastrointestinal stromal tumors/smooth muscle tumors (GISTs) primary in the omentum and mesentery: Clinicopathologic and immunohistochemical study of 26 cases. Am J Surg Pathol. 23:1109–1118. 1999. View Article : Google Scholar : PubMed/NCBI
8	Reith JD, Goldblum JR, Lyles RH and Weiss SW: Extragastrointestinal (soft tissue) stromal tumors: An analysis of 48 cases with emphasis on histologic predictors of outcome. Mod Pathol. 13:577–585. 2000. View Article : Google Scholar : PubMed/NCBI
9	Miettinen M and Lasota J: Gastrointestinal stromal tumors: Pathology and prognosis at different sites. Semin Diagn Pathol. 23:70–83. 2006. View Article : Google Scholar : PubMed/NCBI
10	Terada T: Gastrointestinal stromal tumor of the uterus: A case report with genetic analyses of c-kit and PDGFRA genes. Int J Gynecol Pathol. 28:29–34. 2009. View Article : Google Scholar : PubMed/NCBI
11	Neto MR, Machuca TN, Pinho RV, Yuasa LD and Bleggi-Torres LF: Gastrointestinal stromal tumor: Report of two unusual cases. Virchows Arch. 444:594–596. 2004. View Article : Google Scholar : PubMed/NCBI
12	Yamaura K, Kato K, Miyazawa M, Haba Y, Muramatsu A, Miyata K and Koide N: Stromal tumor of the pancreas with expression of c-kit protein: Report of a case. J Gastroenterol Hepatol. 19:467–470. 2004. View Article : Google Scholar : PubMed/NCBI
13	Krska Z, Pesková M, Povýsil C, Horejs J, Sedlácková E and Kudrnová Z: GIST of pancreas. Prague Med Rep. 106:201–208. 2005.PubMed/NCBI
14	Daum O, Klecka J, Ferda J, Treska V, Vanecek T, Sima R, Mukensnabl P and Michal M: Gastrointestinal stromal tumor of the pancreas: Case report with documentation of KIT gene mutation. Virchows Arch. 446:470–472. 2005. View Article : Google Scholar : PubMed/NCBI
15	Showalter SL, Lloyd JM, Glassman DT and Berger AC: Extra-gastrointestinal stromal tumor of the pancreas: Case report and a review of the literature. Arch Surg. 143:305–308. 2008. View Article : Google Scholar : PubMed/NCBI
16	Yan BM, Pai RK and Van Dam J: Diagnosis of pancreatic gastrointestinal stromal tumor by EUS guided FNA. JOP. 9:192–196. 2008.PubMed/NCBI
17	Yang F, Jin C, Fu D and Ni Q: Extra-gastrointestinal stromal tumor of the pancreas: Clinical characteristics, diagnosis, treatment, and outcome. J Surg Oncol. 103:739–740. 2011. View Article : Google Scholar : PubMed/NCBI
18	Harindhanavudhi T, Tanawuttiwat T, Pyle J and Silva R: Extra-gastrointestinal stromal tumor presenting as hemorrhagic pancreatic cyst diagnosed by EUS-FNA. JOP. 10:189–191. 2009.PubMed/NCBI
19	Trifan A, Târcoveanu E, Danciu M, Hutanasu C, Cojocariu C and Stanciu C: Gastric heterotopic pancreas: An unusual case and review of the literature. J Gastrointestin Liver Dis. 21:209–212. 2012.PubMed/NCBI
20	Goh BK, Kesavan SM and Wong WK: An unusual cause of a pancreatic head tumor. Gastroenterology. 137:e5–e6. 2009. View Article : Google Scholar : PubMed/NCBI
21	Padhi S, Kongara R, Uppin SG, Uppin MS, Prayaga AK, Challa S, Nagari B and Regulagadda SA: Extragastrointestinal stromal tumor arising in the pancreas: A case report with a review of the literature. JOP. 11:244–248. 2010.PubMed/NCBI
22	Saif MW, Hotchkiss S and Kaley K: Gastrointestinal stromal tumors of the pancreas. JOP. 11:405–406. 2010.PubMed/NCBI
23	Rao RN, Vij M, Singla N and Kumar A: Malignant pancreatic extra-gastrointestinal stromal tumor diagnosed by ultrasound guided fine needle aspiration cytology. A case report with a review of the literature. JOP. 12:283–286. 2011.PubMed/NCBI
24	Čečka F, Jon B, Ferko A, Šubrt Z, Nikolov DH and Tyčová V: Long-term survival of a patient after resection of a gastrointestinal stromal tumor arising from the pancreas. Hepatobiliary Pancreat Dis Int. 10:330–332. 2011. View Article : Google Scholar : PubMed/NCBI
25	Vij M, Agrawal V and Pandey R: Malignant extra-gastrointestinal stromal tumor of the pancreas. A case report and review of literature. JOP. 12:200–204. 2011.PubMed/NCBI
26	Soufi M, Bouziane M, Massrouri R and Chad B: Pancreatic GIST with pancreas divisum: A new entity. Int J Surg Case Rep. 4:68–71. 2013. View Article : Google Scholar : PubMed/NCBI
27	Kim HH, Koh YS, Park EK, Seoung JS, Hur YH, Kim JC, Cho CK and Kim HJ: Primary extragastrointestinal stromal tumor arising in the pancreas: Report of a case. Surg Today. 42:386–390. 2012. View Article : Google Scholar : PubMed/NCBI
28	Beltrame V, Gruppo M, Pastorelli D, Pizzi S, Merigliano S and Sperti C: Extra-gastrointestinal stromal tumor of the pancreas: Case report and review of the literature. World J Surg Oncol. 12:1052014. View Article : Google Scholar : PubMed/NCBI
29	Hu X, Forster J and Damjanov I: Primary malignant gastrointestinal stromal tumor of the liver. Arch Pathol Lab Med. 127:1606–1608. 2003.PubMed/NCBI
30	Chen J, Du YJ, Song JTELN and Liu BR: Primary malignant liver mesenchymal tumor: A case report. World J Gastroenterol. 16:5263–5266. 2010. View Article : Google Scholar : PubMed/NCBI
31	Kim HO, Kim JE, Bae KS, Choi BH, Jeong CY and Lee JS: Imaging findings of primary malignant gastrointestinal stromal tumor of the liver. Jpn J Radiol. 32:365–370. 2014. View Article : Google Scholar : PubMed/NCBI
32	van der Zwan SM and De Matteo RP: Gastrointestinal stromal tumor: 5 years later. Cancer. 104:1781–1788. 2005. View Article : Google Scholar : PubMed/NCBI
33	Shinomura Y, Kinoshita K, Tsutsui S and Hirota S: Pathophysiology, diagnosis, and treatment of gastrointestinal stromal tumors. J Gastroenterol. 40:775–780. 2005. View Article : Google Scholar : PubMed/NCBI
34	Rubin BP: Gastrointestinal stromal tumours: An update. Histopathology. 48:83–96. 2006. View Article : Google Scholar : PubMed/NCBI
35	Larsen LP: Role of contrast enhanced ultrasonography in the assessment of hepatic metastases: A review. World J Hepatol. 2:8–15. 2010.PubMed/NCBI
36	Li R, Yuan MX, Ma KS, Li XW, Tang CL, Zhang XH, Guo DY and Yan XC: Detailed analysis of temporal features on contrast enhanced ultrasound may help differentiate intrahepatic cholangiocarcinoma from hepatocellular carcinoma in cirrhosis. PLoS One. 9:e986122014. View Article : Google Scholar : PubMed/NCBI
37	Welch DR: Do we need to redefine a cancer metastasis and staging definitions? Breast Dis. 26:3–12. 2006.PubMed/NCBI
38	Popescu LM, Hinescu ME, Ionescu N, Ciontea SM, Cretoiu D and Ardelean C: Interstitial cells of Cajal in pancreas. J Cell Mol Med. 9:169–190. 2005. View Article : Google Scholar : PubMed/NCBI
39	Arora A and Scholar EM: Role of tyrosine kinase inhibitors in cancer therapy. J Pharmacol Exp Ther. 315:971–979. 2005. View Article : Google Scholar : PubMed/NCBI