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Cystic changes in intraabdominal extrahepatic metastases from gastrointestinal stromal tumors treated with imatinib.

Kim HC, Lee JM, Choi SH, Han H, Kim SS, Lee SH, Han JK, Choi BI - Korean J Radiol (2004 Jul-Sep)

Bottom Line: The metastatic lesions were assessed according to the location, size (greatest diameter), attenuation, and the enhancing pattern before and after imatinib treatment.Prior to the treatment, the sizes and attenuation values of the metastatic lesions ranged from 5 to 20 cm and from 63 to 131 H, respectively.After the treatment, the metastatic lesions became smaller in all 11 patients, and the corresponding attenuation value ranged from 15 to 51 H.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, SNUMRC, Chongno-gu, Korea.

ABSTRACT

Objective: This study was undertaken for the purpose of describing the CT features of intra-abdominal extra-hepatic metastases from gastrointestinal stromal tumors in patients who were treated with imatinib.

Materials and methods: Eleven patients with intra-abdominal extra-hepatic metastases from gastrointestinal stromal tumors, who were treated with imatinib between May 2001 and December 2003, were included in this study. The clinical findings and CT scans were retrospectively reviewed. The metastatic lesions were assessed according to the location, size (greatest diameter), attenuation, and the enhancing pattern before and after imatinib treatment.

Results: Prior to the treatment, the sizes and attenuation values of the metastatic lesions ranged from 5 to 20 cm and from 63 to 131 H, respectively. The metastatic lesions showed a heterogeneous enhancement pattern on the contrast-enhanced CT scans. After the treatment, the metastatic lesions became smaller in all 11 patients, and the corresponding attenuation value ranged from 15 to 51 H. The metastatic lesions became homogeneous and cystic in appearance on the follow-up CT scans, mimicking ascites.

Conclusion: Intra-abdominal extra-hepatic metastases of patients with gastrointestinal stromal tumors treated with imatinib may appear as well-circumscribed cystic lesions on contrast-enhanced CT. These metastases are likely to become smaller and resemble ascites, but may persist indefinitely on the followup CT.

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Related in: MedlinePlus

A 34-year-old man with peritoneal seeding and liver metastases after resection of gastrointestinal stromal tumor of the duodenum.A. CT scan before treatment shows multiple heterogeneous masses (82 H) (M) compressing inferior vena cava (arrowhead) and superior mesenteric vein (arrow). Metastatic lesion in liver (curved arrow).B. CT scan obtained after 8 weeks of treatment with imatinib shows peritoneal and hepatic metastases that have decreased in size and density (35 H). Note the decompressed inferior vena cava and superior mesenteric vein and shrunk metastatic lesions in the liver.C. CT scan obtained 2 months after stopping imatinib therapy shows increased size and density of peritoneal and hepatic metastases. After resumption of imatinib therapy, the metastatic lesions showed cystic changes again (now shown).
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Figure 1: A 34-year-old man with peritoneal seeding and liver metastases after resection of gastrointestinal stromal tumor of the duodenum.A. CT scan before treatment shows multiple heterogeneous masses (82 H) (M) compressing inferior vena cava (arrowhead) and superior mesenteric vein (arrow). Metastatic lesion in liver (curved arrow).B. CT scan obtained after 8 weeks of treatment with imatinib shows peritoneal and hepatic metastases that have decreased in size and density (35 H). Note the decompressed inferior vena cava and superior mesenteric vein and shrunk metastatic lesions in the liver.C. CT scan obtained 2 months after stopping imatinib therapy shows increased size and density of peritoneal and hepatic metastases. After resumption of imatinib therapy, the metastatic lesions showed cystic changes again (now shown).

Mentions: After the treatment, the mean size of the metastatic lesions was 5.8±3.6, ranging from 3 to 15 cm, on the first follow-up CT scan, showing a reduction in size for all 11 patients. On the first follow-up CT scan, the attenuation of the metastatic lesions was homogeneous in eight patients (Figs. 1 and 2), and heterogeneous in three patients (Fig. 3). In cases of peritoneal seeding, the metastatic lesions developed a cystic appearance, mimicking ascites (Figs. 2 and 3). In reviewing the original CT reports, it was found that the cystic change of the tumor was described as ascites or fluid collection in three patients.


Cystic changes in intraabdominal extrahepatic metastases from gastrointestinal stromal tumors treated with imatinib.

Kim HC, Lee JM, Choi SH, Han H, Kim SS, Lee SH, Han JK, Choi BI - Korean J Radiol (2004 Jul-Sep)

A 34-year-old man with peritoneal seeding and liver metastases after resection of gastrointestinal stromal tumor of the duodenum.A. CT scan before treatment shows multiple heterogeneous masses (82 H) (M) compressing inferior vena cava (arrowhead) and superior mesenteric vein (arrow). Metastatic lesion in liver (curved arrow).B. CT scan obtained after 8 weeks of treatment with imatinib shows peritoneal and hepatic metastases that have decreased in size and density (35 H). Note the decompressed inferior vena cava and superior mesenteric vein and shrunk metastatic lesions in the liver.C. CT scan obtained 2 months after stopping imatinib therapy shows increased size and density of peritoneal and hepatic metastases. After resumption of imatinib therapy, the metastatic lesions showed cystic changes again (now shown).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2698157&req=5

Figure 1: A 34-year-old man with peritoneal seeding and liver metastases after resection of gastrointestinal stromal tumor of the duodenum.A. CT scan before treatment shows multiple heterogeneous masses (82 H) (M) compressing inferior vena cava (arrowhead) and superior mesenteric vein (arrow). Metastatic lesion in liver (curved arrow).B. CT scan obtained after 8 weeks of treatment with imatinib shows peritoneal and hepatic metastases that have decreased in size and density (35 H). Note the decompressed inferior vena cava and superior mesenteric vein and shrunk metastatic lesions in the liver.C. CT scan obtained 2 months after stopping imatinib therapy shows increased size and density of peritoneal and hepatic metastases. After resumption of imatinib therapy, the metastatic lesions showed cystic changes again (now shown).
Mentions: After the treatment, the mean size of the metastatic lesions was 5.8±3.6, ranging from 3 to 15 cm, on the first follow-up CT scan, showing a reduction in size for all 11 patients. On the first follow-up CT scan, the attenuation of the metastatic lesions was homogeneous in eight patients (Figs. 1 and 2), and heterogeneous in three patients (Fig. 3). In cases of peritoneal seeding, the metastatic lesions developed a cystic appearance, mimicking ascites (Figs. 2 and 3). In reviewing the original CT reports, it was found that the cystic change of the tumor was described as ascites or fluid collection in three patients.

Bottom Line: The metastatic lesions were assessed according to the location, size (greatest diameter), attenuation, and the enhancing pattern before and after imatinib treatment.Prior to the treatment, the sizes and attenuation values of the metastatic lesions ranged from 5 to 20 cm and from 63 to 131 H, respectively.After the treatment, the metastatic lesions became smaller in all 11 patients, and the corresponding attenuation value ranged from 15 to 51 H.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Seoul National University College of Medicine, Institute of Radiation Medicine, SNUMRC, Chongno-gu, Korea.

ABSTRACT

Objective: This study was undertaken for the purpose of describing the CT features of intra-abdominal extra-hepatic metastases from gastrointestinal stromal tumors in patients who were treated with imatinib.

Materials and methods: Eleven patients with intra-abdominal extra-hepatic metastases from gastrointestinal stromal tumors, who were treated with imatinib between May 2001 and December 2003, were included in this study. The clinical findings and CT scans were retrospectively reviewed. The metastatic lesions were assessed according to the location, size (greatest diameter), attenuation, and the enhancing pattern before and after imatinib treatment.

Results: Prior to the treatment, the sizes and attenuation values of the metastatic lesions ranged from 5 to 20 cm and from 63 to 131 H, respectively. The metastatic lesions showed a heterogeneous enhancement pattern on the contrast-enhanced CT scans. After the treatment, the metastatic lesions became smaller in all 11 patients, and the corresponding attenuation value ranged from 15 to 51 H. The metastatic lesions became homogeneous and cystic in appearance on the follow-up CT scans, mimicking ascites.

Conclusion: Intra-abdominal extra-hepatic metastases of patients with gastrointestinal stromal tumors treated with imatinib may appear as well-circumscribed cystic lesions on contrast-enhanced CT. These metastases are likely to become smaller and resemble ascites, but may persist indefinitely on the followup CT.

Show MeSH
Related in: MedlinePlus