Diagnosis of Gastrointestinal Stromal Tumor (GIST) on Transurethral Resection of the Prostate

Abstract

Gastrointesinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract and they show differentiation towards interstitial cells of Cajal (ICC). Herein, we describe a case of a 60-year-old man presenting with symptoms mimicking adenomatous hyperplasia of the prostate that was subjected to repeated transurethral prostatectomies. Histologic and immunohistochemical examination showed a neoplastic process with characteristics consistent with GIST. Imaging studies confirmed a rectal origin of the tumor. Review of the literature revealed 20 cases of GISTs occurring in the prostate gland, either diagnosed as either primary GISTs or, more commonly, as rectal neoplasms extending to this organ. We add our case in this short list, emphasizing on the importance of inclusion of GISTs in the differential diagnosis of every spindle cell lesion encountered in the prostate.

Diagnosis and treatment of gastrointestinal stromal tumor extending to prostate

“…[9] The malignancy standard was debatable, and the criteria accepted by most researchers are deep intramuscular, infiltration of muscularispropria, diameter of neoplasms >5 cm, presence of mitotic figures (one or more per 50 high-power field), and coagulative necrosis and pleomorphism. [1] National Comprehensive Cancer Network (NCCN) published that the multiple disciplinary team (MDT) was important for the treatment of GIST. [10] The combination of iconography evidence and the pathologic analysis lead to the final diagnosis.…”

“…For the big tumor more than 10 cm, adjuvant therapy was necessary for the preoperative treatment of the tumor. Though some of the early publication reported the diagnosis by CD117 positivity will lead to prompt imatinib mesylate introduction and avoidance of the surgical treatment, [1] it is hard for the only imatinib treatment for the huge GIST.…”

“…[1,2] It is rare to initiate from the urinary syndrome such as dysuresia, nocturia, and acute urinary retention, which always originated from the tumor of the anterior rectum wall or prostate.…”

Primary extragastrointestinal stromal tumor of the pleura: A case report

“…The origin of EGISTs remains to be elucidated; however, GISTs and EGISTs have been confirmed to share various clinicopathological and histological features (11). As the presence of GISTs have been observed in numerous organs, including the urinary bladder (21), prostate (22), uterus (23), gall bladder (24) and myocardium (25), it can be assumed that EGISTs originate from common precursor cells that are able to differentiate into ICC-derived neoplasms outside of the gastrointestinal tract during development (26). An alternative explanation is that this type of tumor originates from the pluripotent mesenchymal stem cells located outside the gastrointestinal tract (10).…”

Rectal gastrointestinal stromal tumor with metastasis to the penis: Case report and review of literature

“…A literature review of the metastatic potential of GISTs identified one case of a “lump at the base of the penis” thought to be a metastatic lesion arising from a primary rectal tumor [8]. Although there have been no reported cases of metastatic GIST to the corpora of the penis, cases of GIST metastases to the prostate from primary rectal tumors are documented [9], [10], [11]. In this report, we describe the first documented case of metastatic GIST to the penis.…”