Pelvic Gastrointestinal Stromal Tumor With Pulmonary Metastasis

Abstract

Extragastrointestinal stromal tumors (EGISTs) comprise a small portion of gastrointestinal stromal tumors. Metastasis normally occurs to nearby organs. However, metastasis to the lungs is uncommon in EGISTs. Furthermore, recurrence of the EGIST in a new location years later has not been documented. We present this case to highlight this behavior of EGISTs in hopes to better understand this rare type of neoplasm.

Gastrointestinal stromal tumor of the small intestine with lung metastasis

“…The liver and peritoneum are the most frequent metastatic sites of gastrointestinal stromal tumors (GISTs), but lung metastases from GISTs are relatively rare accounting for 7% of all lesions [ 3 , 4 ].…”

Primary Extragastrointestinal Stromal Tumor of Greater Omentum with Intraperitoneal Bleeding

“…Several reports of EGIST cases with intraperitoneal or distant metastasis have been presented. Jacobs et al (21) and Haba et al (25) reported EGIST findings in patients with liver metastasis, while others treated patients with pulmonary metastasis or peritoneal seeding (26,27). However, the tendency for metastasis in affected patents is unclear, possibly due to the low number of EGIST cases reported.…”

“…In the digestive tract, GISTs have been found in the stomach (60%-70%), small intestine (20-25%), colon (5%), and esophagus (5%) (1). However, a very small number of reports have described GISTs arising from outside of the gastrointestinal tract (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(25)(26)(27), termed extragastrointestinal stromal tumors (EGISTs).…”

Clinical characteristics and prognosis of gastrointestinal stromal tumors with rare site metastasis (Review)

“…In cases of bone metastasis, pain manifests in the affected bone area (29,37,48,52,53,63,69,75,80,94,95), in cases of skeletal muscle involvement, a mass can be palpated in the affected area (34,49,71,72,79), and when metastasis occurs deep in the bone marrow, anemia may be present (96). Furthermore, when GIST metastasizes to the lungs, signs and symptoms that may be observed include dyspnea, blood in the sputum, coughing and shortness of breath (18,85,88,97). When metastasis to superficial lymph nodes, skin or subcutaneous tissue occurs, a mass may be superficially palpable (28,42,45,55,68,68,73,98).…”

“…In cases with the involvement of skeletal muscle, T2-weighted images show a mass with high signal intensity (71,72). When GIST metastasizes to the lungs, a dense mass is visible in one or both lungs (18,85,88,97), and in the lymph nodes, GIST metastasis appears on CT images as a hypodense mass with no enhancement when examined using enhanced MRI (39,57,58) and as a hypoechoic cystic or solid mass when examined using ultrasound (28,33,29). No enhancement is seen on chest enhancement CT images when GIST metastasizes to the heart (85,100), and PET-CT reveals high 18 F-fluorodeoxyglucose accumulation in the mass (24,83), with echocardiograms showing a hypoechoic mass in the ventricle or atrium (24,83,99,100).…”