Hypoglycaemia associated with gastrointestinal and extragastrointestinal stromal tumour in two dogs

Abstract

Gastrointestinal stromal tumours (GISTs) are uncommon mesenchymal tumours that originate from the interstitial cells of Cajal. As these tumours are difficult to distinguish from gastrointestinal smooth muscle tumours using standard histological techniques, their true prevalence may be underestimated. Metabolic and systemic consequences of GISTs are not well described in any species. More rarely, neoplasms with histological and immunohistochemical features similar to GISTs may occur outside the gastrointestinal tract, the so-called extragastrointestinal stromal tumours (EGIST). EGISTs have never been described in the veterinary literature. In this article the authors present and describe clinical findings, management and treatment of two dogs with clinical hypoglycaemia induced by histologically confirmed GIST and EGIST. Hypoglycaemia resolved immediately and long term after tumour excision. To the authors’ knowledge this is the first report of hypoglycaemia associated with a canine GIST and the first case report of an EGIST in a dog.

Gastrointestinal stromal tumour and its systemic effects in a dog

“…To date, hypoglycaemia induced by GIST in dogs has only been described in two studies 5,6 . This paraneoplastic syndrome is not very common in humans; however, as it is the most common primary tumour of the gastrointestinal tract in this species, it has already been well described and reported in the literature 28,29 …”

“…1,2 Gastrointestinal stromal tumours (GIST) have been reported in humans, dogs, domestic cats and other species. [3][4][5][6] They are mesenchymal neoplasms believed to originate from multipotent stem cells that are phenotypically similar to interstitial cells of Cajal (pacemaker cells of the intestinal tract that regulate peristalsis). 1,7 They are the most common primary mesenchymal tumours of the human gastrointestinal tract and commonly occur in the stomach, jejunum and ileum, 8,9 in contrast with dogs in which they frequently occur in the caecum and large intestine.…”

“…Gastrointestinal stromal tumours (GIST) have been reported in humans, dogs, domestic cats and other species 3–6 . They are mesenchymal neoplasms believed to originate from multipotent stem cells that are phenotypically similar to interstitial cells of Cajal (pacemaker cells of the intestinal tract that regulate peristalsis) 1,7 .…”

Probable paraneoplastic leukocytosis in a dog with a gastrointestinal stromal tumor

“…GISTs in people are linked to numerous paraneoplastic syndromes, including hypercalcemia, 24 nephrotic syndrome, 25,26 acquired hemophilia, 27 pemphigus, 28 hypoglycemia, 29 and consumptive hypothyroidism. 30 Conversely, canine GISTs have been described in association with only a few paraneoplastic syndromes, specifically hypoglycemia 31,32 and hypertrophic osteopathy. 33 With the addition of this case report, GISTs should be added to the differential diagnosis list for a dog with severe leukocytosis.…”