Small gastrointestinal stromal tumor concomitant with early gastric cancer: A case report

Lin, Ying-Lung; Tzeng, Jeh-En; Wei, Chang-Kou; Lin, Chih-Wen

doi:10.3748/wjg.v12.i5.815

Cited by 35 publications

(28 citation statements)

References 10 publications

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“…It was reported that H pylori are related to the pathogenesis of gastric carcinoma and mucosaassociated lymphoid tumor [5,6] . We previously reported a case of a 0.4-cm GIST concomitant with an early gastric cancer in 2005 [7] , and between 2003 and 2007, we intermittently detected one case of multiple 0.2-cm to 0.5-cm gastric neuroendocrine tumors and additional 5 cases of 0.4-15 cm gastric GISTs. All except for 2 of the cases yielded positive CLO tests.…”

Section: Discussionmentioning

confidence: 78%

Concomitant gastric carcinoid and gastrointestinal stromal tumors: A case report

Lin

Wei²,

Chiang³

et al. 2008

WJG

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A gastric carcinoid tumor concomitant with gastrointestinal stromal tumor (GIST) is rarely encountered in clinical practice. We report a 65-year-old female who had a 0.8 cm gastric carcinoid tumor on the posterior wall of the upper gastric corpus detected during an esophagogastroduodenoscopy at a routine physical examination, and a concomitant 1.1 cm GIST on the anterior wall of the upper gastric corpus incidentally found during surgery of the gastric carcinoid tumor. Normal serum gastrin level and histological findings suggested that she had a type Ⅲ gastric carcinoid tumor and a GIST which were categorized a very low risk of malignancy, based on their small size and lack of mitosis. Both tumors were treated successfully by surgical excision. The patient had an uneventful recovery. Neither recurrence nor metastasis was found after a 28-mo follow-up.

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Section: Discussionmentioning

confidence: 78%

Concomitant gastric carcinoid and gastrointestinal stromal tumors: A case report

Lin

Wei²,

Chiang³

et al. 2008

WJG

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“…Alternatively, local resection should be performed. [10][11][12] Owing to the presence of incidental GIST, 5 (45%) patients with primary epithelial malignancies in our series required additional procedures intraoperatively. Simple excision or wedge resection was performed in all cases involving the eventual gastric conduit used to restore intestinal continuity.…”

Section: Discussionmentioning

confidence: 99%

The impact of incidental gastrointestinal stromal tumours on patients undergoing resection of upper gastrointestinal neoplasms

Chan¹,

Cools-Lartigue²,

Marcus³

et al. 2012

Can J Surg

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Background: Emerging data suggest asymptomatic gastrointestinal stromal tumours (GISTs) of the upper gastrointestinal (UGI) tract are not uncommon. We sought to determine their incidence in patients undergoing resection for UGI neoplasms and their impact on surgical and adjuvant treatment. Methods:We accessed a database prospectively listing all patients undergoing resection of non-GIST neoplasms of the stomach and esophagus at a single university centre over a 4.5-year period and reviewed pathology reports for the presence of synchronous GISTs in the UGI tract. We compared patient demographic and tumour characteristics, operative procedures and postoperative outcomes. Results:In all, 207 patients undergoing gastrectomy or esophagectomy for non-GIST neoplasms were included. We identified 15 synchronous GISTs in the UGI tract of 11 (5.3%) patients (1 preoperatively, 4 intraoperatively and 10 on final pathology), with an average age of 67 years. Most patients were men. Additional resections were required for GISTs identified pre-or intraoperatively. Final pathology revealed completely resected c-kit positive tumours of an average size of 0.5 (range 0.1-4.0) cm with low or very low risk of malignant potential. No patients received adjuvant therapy for the GISTs. After a median follow-up of 11 (range 2-36) months, 5 patients died from their primary cancer, 3 were alive with primary cancer recurrence, and 3 were alive without disease. No patients experienced GIST recurrence. Conclusion:Incidentally finding a synchronous GIST during resection of UGI neoplasms is not uncommon; it may alter surgical treatment but is unlikely to impact longterm survival.

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“…Simple coincidence appears to be the most likely explanation, although gene mutations or neighboring gastric tissues affected by the same carcinogen are other hypotheses reported in the literature (2,11,12). A combined genetic deregulation appears to be involved in the pathogenesis of these two entities.…”

Section: Discussionmentioning

confidence: 85%

Computed tomography imaging characteristics of synchronous gastrointestinal stromal tumors in patients with gastric cancer and correlation with clinicopathological findings

Shi

Zhuang

2015

Molecular and Clinical Oncology

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Abstract.This study was conducted to analyze the computed tomography (CT) imaging and clinicopathological characteristics of synchronous gastrointestinal stromal tumors (GISTs) in patients with gastric cancer. We retrospectively reviewed the CT images in 18 cases of immunohistochemically confirmed synchronous GISTs in patients with primary gastric cancer. Relevant histology and clinical data were also obtained. Multi-slice CT (MSCT) identified suspected synchronous GISTs in 26 patients, of which 18 were finally confirmed. Of the 18 patients, 12 were male and 6 female, with a mean age of 69.2 years. All 18 lesions were discovered as a solitary mass, ranging in size from 1.0 to 6.5 cm (mean, 2.2 cm). The lesions were predominantly located in the gastric fundus and were characterized by an ovoid shape, well-defined margins and isodensity, with slight to moderate gradual enhancement on MSCT. There was no evidence of necrosis, hemorrhage or cystic degeneration, irrespective of the tumor size. Synchronous GISTs exhibited spindle cell morphological characteristics and specific immunohistochemical properties, and were classified as being of low or very low malignant potential. In conclusion, since gastric cancer patients with a synchronous GIST are rare, a solitary, ovoid and well-defined mass with slight to moderate gradual enhancement following contrast agent injection may be suggestive of this diagnosis, although detection of synchronous GISTs does not appear to significantly affect therapy and outcome. IntroductionGastrointestinal stromal tumor (GIST), the most common type of non-epithelial tumors, is a term used to describe a unique group of mesenchymal neoplasms that typically arise in the muscularis propria of the gastrointestinal tract wall, accounting for 0.1-3% of all gastrointestinal tumors (1). GISTs may develop synchronously with tumors originating from different cell layers, such as cancer, carcinoid and lymphadenoma (2-4). The synchronous development of a gastric GIST and adenocarcinoma is relatively rare. The aim of this study was to conduct a retrospective review of the computed tomography (CT) imaging characteristics of 18 cases of synchronous GIST and primary gastric cancer and evaluate the clinicopathological characteristics of GISTs. Patients and methodsPatients. The database of the First Affiliated Hospital of Fujian Medical University was searched and patients who were treated at our hospital between January, 2006 and April, 2013 were identified. A total of 26 patients with histologically proven synchronous GISTs and gastric cancer were investigated. Of these patients, 8 with GISTs sized <1.0 cm were excluded, as the preoperative CT images were difficult to characterize with confidence. Therefore, the study cohort consisted of 18 patients (12 men and 6 women; mean age, 69.2 years; and age range, 47-82 years). An Institutional Review Board (IRB) exemption and a waiver of the requirement for written informed consent were obtained to perform this retrospective study. The patient characteristics are s...

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Small gastrointestinal stromal tumor concomitant with early gastric cancer: A case report

Cited by 35 publications

References 10 publications

Concomitant gastric carcinoid and gastrointestinal stromal tumors: A case report

Concomitant gastric carcinoid and gastrointestinal stromal tumors: A case report

The impact of incidental gastrointestinal stromal tumours on patients undergoing resection of upper gastrointestinal neoplasms

Computed tomography imaging characteristics of synchronous gastrointestinal stromal tumors in patients with gastric cancer and correlation with clinicopathological findings

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