Occurrence of other malignancies in patients with gastrointestinal stromal tumors

Agaimy, Abbas; Wünsch, Peter H.; Sobin, Leslie H.; Lasota, Jerzy; Miettinen, Markku

doi:10.1053/j.semdp.2006.09.004

Cited by 190 publications

(224 citation statements)

References 59 publications

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“…This may recall the phenomenon of ''field cancerization,'' reported for the mucosa of the upper respiratory tract (37). In agreement with this hypothesis, Agaimy and coworkers (38) have recently reported that multiple minute (f4 mm), hyalinizing spindle cell lesions are a common finding in the stomach of adult individuals (f20%) and that these nodules, named GIST ''tumorlets,'' are CD117 positive and carry KIT/PDGFRA gene mutations. The authors suggest that GIST tumorlets represent early mesenchymal cell lesions that may eventually, under endogenous or exogenous stimuli, evolve into clinically overt GIST.…”

Section: Discussionsupporting

confidence: 54%

Multiple Primary Sporadic Gastrointestinal Stromal Tumors in the Adult: An Underestimated Entity

Gasparotto

Rossi

Bearzi

et al. 2008

Clinical Cancer Research

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Purpose: Gastrointestinal stromal tumors (GIST) are commonly regarded as solitary tumors.The occurrence of multiple lesions is considered an extraordinary event restricted to pediatric GISTs and rare hereditary conditions. Beyond these well-defined situations, the presentation of multiple synchronous lesions is commonly viewed as the result of the metastatic spreading of a single primary GIST. Based on this axiom, patients with multifocal disease are classified as advanced stage and treated as such.Whether, indeed, the detection of several lesions in sporadic adult GIST patients may be suggestive of phenomena of tumor multiplicity still needs to be clarified. Experimental Design: From a multicentric series of 442 consecutive cases, 26 of which with advanced disease, we selected 5 patients who presented up to three distinct GIST nodules. Five additional cases with similar characteristics were also contributed by two other institutions. The clonal relationship between the synchronous lesions was assessed by comparing KIT/PDGFRA mutation and microsatellite pattern. Results: An independent origin of the synchronous lesions was established in 6 of 10 cases. Notably, in one patient, one lesion arose in the peritoneum, which is ordinarily regarded as a site of metastasis. Conclusions: Our data indicate that a significant fraction of GIST patients with multifocal presentation are actually affected by multiple primary tumors, suggesting that mesenchymal GIST precursor cells of these individuals are somehow primed to transformation. Thus, in the presence of multifocal GIST manifestations, an accurate characterization of the different tumor sites should be undertaken for a proper patient staging and therapy planning.

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Section: Discussionsupporting

confidence: 54%

Multiple Primary Sporadic Gastrointestinal Stromal Tumors in the Adult: An Underestimated Entity

Gasparotto

Rossi

Bearzi

et al. 2008

Clinical Cancer Research

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“…Two or more different synchronous or metachronous cancers were present in 34 (18.6 %) patients with histologically confi rmed GIST. The increased incidence of multiplied cancers with the presence of GIST has been described in literature (8). There were 60 males and 36 females with the median age 63 years and mean age 60 years who were treated with imatinib mesylate in palliative setting during the course of their disease.…”

Section: Resultsmentioning

confidence: 99%

Long term experience of patients with unresectable or metastatic KIT positive gastrointestinal stromal tumours

Kocáková¹,

Kocák²,

Špelda³

et al. 2015

BLL

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A retrospective analysis of consecutive patients (183 in total, of which 105 were males and 78 females) with gastrointestinal stromal tumour (GIST) was performed. The mean age was 61 years, median age 64 years. The most frequent localization of the tumour was stomach in 74 patients (40.4 %) and the small intestine in 46 patients (25.1 %). Two or more different synchronous or metachronous cancers occurred in 34 (18.6 %) patients with histologically confi rmed GIST. Ninety-six patients were treated with imatinib mesylate in palliative setting during the course of their disease. The therapy was fi nished in 60 patients and 36 patients have been treated so far. The median progression-free survival reached 32.9 months in the group of 96 patients treated with imatinib. The median overall survival in the group of 96 patients treated for metastatic disease reached 77 months. Two-year and 5-year survival was 85.2 % and 63.1 %, respectively. The second-line therapy with sunitinib malate was administered in 37 patients, of which 31 fi nished and 6 continued in the therapy. The median progression free survival and median survival since the sunitinib therapy initiation reached 8.4 and 22.1 months, respectively (Tab. 2, Fig. 2

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“…An immuno-histo-chemical feature of stromal tumors associated with adenocarcinoma is the low expression of CD117 and CD34 [7] with often an intense expression of the DOG-1 [8].…”

Section: Discussionmentioning

confidence: 99%

Gastric Synchronous Stromal Tumor and Adenocarcinoma: A Fortuitous Association?

Anis¹,

Kacem²,

Amine³

et al. 2017

J Clin Exp Pathol

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The association of an adenocarcinoma with a stromal tumor in the stomach is rarely observed. We report the observation of a patient operated for a synchronous tumor associating subcardial adenocarcinoma with a stromal tumor of the gastric body. It is a 74 year-old patient, diabetic, who was admitted, in December 2016, for epigastralgia associated with vomiting evolving for 2 months. Physical examination was strictly normal. An oesogastroduodenal fibroscopy was performed showing a subcardial ulcerative budding formation with a 3 cm diameter and the presence, in the gastric body, of a second sub mucosal nodular formation with a 4 cm diameter. The anatomopathological examination of the biopsies concluded to an infiltrating and slightly differentiated adenocarcinoma at the subcardial level associated with chronic HP+ gastritis without signs of malignancy. The computed tomography, performed as part of the extension study, revealed a macro-lobulated tissue mass, posterior, pre-pyloric, with submucosal development, prolapsed in the peritoneum whose enhancement characteristics evoke a stromal tumor but also an irregular gastric cardio-tuberosal thickening predominant on the small gastric curvature and associated with necrotic pre-gastric centimetric satellite ganglia. The patient had a total gastrectomy with lymph node dissection type D1, 5 and oesojejunal anastomosis on a Y-shaped loop. The anatomo-pathological examination of the surgical specimen concluded to a slightly differentiated adenocarcinoma of the cardia classified as pT3N2 associated with a stromal tumor of the gastric body Synchronous development of gastric adenocarcinoma and GIST is rare. During this association, the stromal tumor is often characterized by low risk of recidivism.

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Occurrence of other malignancies in patients with gastrointestinal stromal tumors

Cited by 190 publications

References 59 publications

Multiple Primary Sporadic Gastrointestinal Stromal Tumors in the Adult: An Underestimated Entity

Multiple Primary Sporadic Gastrointestinal Stromal Tumors in the Adult: An Underestimated Entity

Long term experience of patients with unresectable or metastatic KIT positive gastrointestinal stromal tumours

Gastric Synchronous Stromal Tumor and Adenocarcinoma: A Fortuitous Association?

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