Extragastrointestinal Stromal Tumor during Pregnacy

Gözükara, İlay; Dilek, Talat Umut Kutlu; Durukan, Hüseyin; Apa, Duygu Düşmez; Kucur, Suna Kabil; Dılek, Saffet

doi:10.1155/2012/846747

Cited by 7 publications

(7 citation statements)

References 10 publications

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“…More than half of these cases were thought to be adnexal or uterine masses prior to surgery, based on imaging and clinical presentation. 13–21 Thus, GISTs represent a diagnostic challenge during pregnancy and may be encountered unexpectedly at the time of surgery for a presumed adnexal mass. As such, it is important for obstetricians and gynecologists to counsel women preoperatively that an “adnexal mass” may actually be arising from the gastrointestinal tract.…”

Section: Discussionmentioning

confidence: 99%

A NovelPRKAR1B-BRAFFusion in Gastrointestinal Stromal Tumor Guides Adjuvant Treatment Decision-Making During Pregnancy

Charo¹,

Burgoyne²,

Fanta³

et al. 2018

J Natl Compr Canc Netw

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Gastrointestinal stromal tumors (GISTs) are rare in pregnancy, with only 11 reported cases. Adjuvant imatinib therapy, which targets the most common driver mutations in GIST (KIT and PDGFRA), is recommended for patients with high-risk GIST, but it has known teratogenicity in the first trimester. A 34-year-old G3P2 woman underwent exploratory laparotomy at 16 weeks’ gestation for a presumed adnexal mass. Surgical findings included normal adnexa and a 14-cm solid small bowel mass. The mass was resected en bloc with a segment of jejunum followed by a primary anastomosis. Histopathology and genomic analyses demonstrated a GIST with high-risk features but lack of KIT/PDG-FRA mutations and identified the presence of a previously unreported, pathogenic PRKAR1B-BRAF gene fusion. Given her tumor profile, adjuvant therapy with imatinib was not recommended. GIST is rare in pregnancy, but can masquerade as an adnexal mass in women of childbearing age. Because neoadjuvant/adjuvant imatinib has risks of teratogenicity, tumor molecular profiling is critical as we identified a previously unreported gene fusion of PRKAR1B with BRAF that is predicted to be imatinib-resistant. In this case, testing provided the rationale for not offering adjuvant imatinib to avoid unnecessary toxicity to the patient and fetus.

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Section: Discussionmentioning

confidence: 99%

A NovelPRKAR1B-BRAFFusion in Gastrointestinal Stromal Tumor Guides Adjuvant Treatment Decision-Making During Pregnancy

Charo¹,

Burgoyne²,

Fanta³

et al. 2018

J Natl Compr Canc Netw

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“…Imatinib treatment during pregnancy or breast feeding is contra-indicated since spontaneous miscarriages and birth defects have been reported. Prognosis of women with gestational GIST remains favorable [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] .…”

Section: Literature Searchmentioning

confidence: 99%

Bone and soft tissue sarcomas during pregnancy: A narrative review of the literature

Zarkavelis

Petrakis

Fotopoulos

et al. 2016

Journal of Advanced Research

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“…A total of 12 cases were retrieved from the literature regarding women who were diagnosed with GIST during the gestational period [5][6][7][8][9][10][11][12][13][14][15][16]. The median maternal age and the median gestational age during GIST diagnosis were 31 years old (range 21-42 years) and 18 weeks (range 10-28 years), respectively.…”

Section: Resultsmentioning

confidence: 99%

Gastrointestinal stromal tumors during pregnancy: a systematic review of an uncommon but treatable malignancy

2015

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Although modern social structure and medical advances have led to the increasing number of women childbearing in older age, cancer remains a rare diagnosis during pregnancy. There is little given information throughout the literature concerning gestation associated with the coexistence of gastrointestinal stromal tumor (GIST). In this review, we present 12 reported cases of GIST during pregnancy and we discuss the maternal and fetal outcome, as well as the therapeutic plan that was followed in each situation. From the collected data, 8 out of 12 cases had an uneventful outcome of their fetus. In 11 out of 12 cases surgical excision of the tumor was the treatment of choice, while seven women were treated with imatinib. Two of them were already on imatinib therapy during conception due to preexisting GIST diagnosis. Surgery remains the gold standard for the treatment of local or resectable GIST, while published data concerning the use of imatinib during pregnancy indicate that teratogenicity or fetal loss might be induced, especially if given during the first trimester of pregnancy. GIST during gestational period is a rare tumor in which a multidisciplinary approach should be designed, taking always into consideration that it has a favorable outcome on targeted treatment.

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Extragastrointestinal Stromal Tumor during Pregnacy

Cited by 7 publications

References 10 publications

A NovelPRKAR1B-BRAFFusion in Gastrointestinal Stromal Tumor Guides Adjuvant Treatment Decision-Making During Pregnancy

A NovelPRKAR1B-BRAFFusion in Gastrointestinal Stromal Tumor Guides Adjuvant Treatment Decision-Making During Pregnancy

Bone and soft tissue sarcomas during pregnancy: A narrative review of the literature

Gastrointestinal stromal tumors during pregnancy: a systematic review of an uncommon but treatable malignancy

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