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Bone metastasis of a gastrointestinal stromal tumor: A report of two cases.

Suzuki K, Yasuda T, Nagao K, Hori T, Watanabe K, Kanamori M, Kimura T - Oncol Lett (2015)

Bottom Line: 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.If feasible, bone metastases should be completely surgically excised.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, University of Toyama, Toyama, Toyama 930-0194, Japan.

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.

No MeSH data available.


Related in: MedlinePlus

Case one: Histopathological appearance of the surgical specimen. (A) The resected mass revealing a hypercellular tumor with spindle-shaped cells. Mitotic index was 70 per 50 high-power fields (hematoxylin and eosin stain; scale bar, 50 μm). Immunohistochemical staining for (B) c-KIT and (C) cluster of differentiation 34 revealing diffuse staining of the cell membrane. (D) Negative staining results obtained for S-100.
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f3-ol-09-04-1814: Case one: Histopathological appearance of the surgical specimen. (A) The resected mass revealing a hypercellular tumor with spindle-shaped cells. Mitotic index was 70 per 50 high-power fields (hematoxylin and eosin stain; scale bar, 50 μm). Immunohistochemical staining for (B) c-KIT and (C) cluster of differentiation 34 revealing diffuse staining of the cell membrane. (D) Negative staining results obtained for S-100.

Mentions: A 78-year-old male had previously undergone surgical removal of a stomach GIST in 2004. The patient subsequently fell and fractured the left femoral neck in September 2009. Although osteosynthesis of the femoral neck was performed at a previous hospital, union of the femoral neck was not achieved and the patient reported a painful, swollen mass in the left buttock. Plain radiographs revealed non-union at the surgical site and a mass in the soft-tissue of the buttock. Magnetic resonance imaging of the hip identified a giant mass spreading around the left buttock from the femoral neck (Fig. 1). A biopsy was performed at the previous hospital, and a diagnosis of synovial sarcoma was suggested. The patient was admitted to Toyama University Hospital (Toyama, Japan) in 2009, where wide resection of the tumor and reconstruction of the hip joint using a tumor prosthesis were performed (Fig. 2). Histopathological examination revealed a hypercellular spindle-cell neoplasm, with a severe mitotic index of 70 per 50 high-power fields (Fig. 3A). Immunohistochemically, the tumor cells were positive for c-KIT and cluster of differentiation (CD)34, but negative for S-100 protein (Fig. 3B–D). Chemotherapy was administered, which consisted of treatment with imatinib (300 mg, daily) for four years. The patient remains alive at four years post-surgery and is able to walk unaided.


Bone metastasis of a gastrointestinal stromal tumor: A report of two cases.

Suzuki K, Yasuda T, Nagao K, Hori T, Watanabe K, Kanamori M, Kimura T - Oncol Lett (2015)

Case one: Histopathological appearance of the surgical specimen. (A) The resected mass revealing a hypercellular tumor with spindle-shaped cells. Mitotic index was 70 per 50 high-power fields (hematoxylin and eosin stain; scale bar, 50 μm). Immunohistochemical staining for (B) c-KIT and (C) cluster of differentiation 34 revealing diffuse staining of the cell membrane. (D) Negative staining results obtained for S-100.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4356394&req=5

f3-ol-09-04-1814: Case one: Histopathological appearance of the surgical specimen. (A) The resected mass revealing a hypercellular tumor with spindle-shaped cells. Mitotic index was 70 per 50 high-power fields (hematoxylin and eosin stain; scale bar, 50 μm). Immunohistochemical staining for (B) c-KIT and (C) cluster of differentiation 34 revealing diffuse staining of the cell membrane. (D) Negative staining results obtained for S-100.
Mentions: A 78-year-old male had previously undergone surgical removal of a stomach GIST in 2004. The patient subsequently fell and fractured the left femoral neck in September 2009. Although osteosynthesis of the femoral neck was performed at a previous hospital, union of the femoral neck was not achieved and the patient reported a painful, swollen mass in the left buttock. Plain radiographs revealed non-union at the surgical site and a mass in the soft-tissue of the buttock. Magnetic resonance imaging of the hip identified a giant mass spreading around the left buttock from the femoral neck (Fig. 1). A biopsy was performed at the previous hospital, and a diagnosis of synovial sarcoma was suggested. The patient was admitted to Toyama University Hospital (Toyama, Japan) in 2009, where wide resection of the tumor and reconstruction of the hip joint using a tumor prosthesis were performed (Fig. 2). Histopathological examination revealed a hypercellular spindle-cell neoplasm, with a severe mitotic index of 70 per 50 high-power fields (Fig. 3A). Immunohistochemically, the tumor cells were positive for c-KIT and cluster of differentiation (CD)34, but negative for S-100 protein (Fig. 3B–D). Chemotherapy was administered, which consisted of treatment with imatinib (300 mg, daily) for four years. The patient remains alive at four years post-surgery and is able to walk unaided.

Bottom Line: 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.If feasible, bone metastases should be completely surgically excised.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, University of Toyama, Toyama, Toyama 930-0194, Japan.

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.

No MeSH data available.


Related in: MedlinePlus