Synchronous Tumors: Adenosquamous Carcinoma of Pancreas and GIST of Stomach

Dasanu, Constantin A; Mesologites, Thalia; Trikudanathan, Guru

doi:10.1007/s12029-010-9187-3

Cited by 10 publications

(9 citation statements)

References 6 publications

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“…Contrary to the majority of previous cases of synchronous GISTs and other malignancies (9,10), and the other case report of synchronous GIST and pancreatic adenocarcinoma (8), in our case, GIST was not an incidental finding. Our initial impression was a symptomatic GIST; however, following reevaluation via a CT scan with a multidisciplinary approach, a pancreatic adenocarcinoma was suspected.…”

Section: Discussioncontrasting

confidence: 99%

“…Previous studies identify an incidence rate of 2.5% (3/119) (5), 7.7% (39/506) (6) and 10.7% (6/56) (7) of pancreatic malignancies. To the best of our knowledge, only one case in the literature demonstrated coexistence of ASC of the head of the pancreas with GIST (8), and the small GIST in this patient was only incidentally identified following surgery. With approved patient consent, we report a case of ASC of the uncinate process of the pancreas with the synchronous occurrence of large symptomatic GIST.…”

Section: Introductionmentioning

confidence: 74%

“…Without the presence of Carney's triad or neurofibromatosis syndromes, synchronous occurrence of a GIST with a tumor of different histological type is rare and has been documented in the literature mainly in the form of case reports. Malignances of the gastrointestinal tract are the most commonly accompanied neoplasms; however, there are few previous studies concerning synchronous pancreatic cancer and GIST in the stomach (8,9). Liu et al reported that the most common epithelial tumors associated with GIST in their series were esophageal squamous cell carcinomas (1.13%), followed by gastric (0.53%), pancreatic (0.38%) and colorectal (0.03%) adenocarcinomas (9).…”

Section: Discussionmentioning

confidence: 99%

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Adenosquamous carcinoma of the uncinate process of the pancreas with synchronous gastrointestinal stromal tumor of the stomach: Case report and review of the literature

Ding

Zheng

et al. 2012

Oncology Letters

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Abstract.Recently, the coexistence of gastrointestinal stromal tumors (GISTs) with other neoplasms has been studied with increasing frequency. Coexistence of pancreatic cancer with GISTs remains a rarity; however, here, we report a very rare case of adenosquamous carcinoma (ASC) of the uncinate process of the pancreas with synchronous GISTs of the stomach in a 62-year-old female. The patient presented with epigastric discomfort and vomiting. Radiographic imaging revealed two masses; one located at the body of the stomach and the other located at the uncinate process of the pancreas. Intraoperatively, a fine needle aspiration biopsy was conducted in the uncinate process of the pancreas, which revealed the malignancy of the masses. A pancreaticoduodenectomy and partial gastrectomy were then conducted, and subsequent pathological examinations identified an ASC of the pancreas and a GIST of the stomach. In our case, contrary to the majority of previous cases of synchronous GISTs and other malignancies, GIST was not an incidental finding. The initial suspicion on the GIST as the underlying cause of clinical symptoms led to the discovery of the ASC of the uncinate process of the pancreas. IntroductionRecently, the synchronous occurrence of primary neoplasms has been studied with increasing frequency, which may be due to the improved preoperative imaging capabilities. The coexistence of gastrointestinal stromal tumors (GISTs) with other gastrointestinal or non-gastrointestinal malignancies has also been studied with increasing frequency, although the occurrence remains rare (1). It has been identified that the overall frequency of second tumors in different sites among patients with GISTs ranges between 4.5 and 18.6%, with a mean of 13% (2).GISTs are the most common type of mesenchymal tumor of the gastrointestinal tract, which most likely arise from precursor interstitial cells of Cajal. The majority of GISTs occur as a single lesion. They are common in the stomach (60-70% of all cases) and small intestine (30%), while they rarely occur in the rectum (5%), esophagus, colon, pancreas, appendix, omentum, mesentery and retroperitoneum (3). The best survival predictors are the size, location and mitotic rate of the tumor.Pancreatic cancer is a common gastrointestinal malignancy. Ductal adenocarcinoma accounts for 80-85% of pancreatic tumors, while adenosquamous carcinoma (ASC) of the pancreas is a rare, aggressive variant of pancreatic carcinoma with a worse prognosis. Its exact incidence is not known; however, autopsy and surgical specimen findings suggest that this lesion accounts for 1-4% of all exocrine malignancies of the pancreas (4).The uncinate process is a hook-like extension of the lower part of the pancreatic head that projects medially and wraps around the superior mesenteric vessels. Carcinoma in the uncinate process of the pancreas (CUPP) appears to be less common than that in other parts of the pancreas. Previous studies identify an incidence rate of 2.5% (3/119) (5), 7.7% (39/506) (6) and 10.7% (6/56) (7) ...

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 99%

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Adenosquamous carcinoma of the uncinate process of the pancreas with synchronous gastrointestinal stromal tumor of the stomach: Case report and review of the literature

Ding

Zheng

et al. 2012

Oncology Letters

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“…La publicación reciente de una serie importante proveniente de una institución en la China continental, mostró que la presencia de GIST esporádicos concurrentes con otros tumores malignos del tracto gastrointestinal o adenocarcinomas pancreáticos es infrecuente y ocurre con una incidencia de 0,3%, el mismo reporte mostró una incidencia específica de 0,2% para adenocarcinoma pancreático asociado a GIST gástrico 8 . Otros casos de tumores pancreáticos malignos asociados a GIST gástrico han sido reportados, incluyendo tumores endocrinos, adenocarcinoma y carcinoma adenoescamoso, comprometiendo la papila de Vater, la cabeza del páncreas y el proceso uncinado, todos ellos tratados mediante pancreatoduodenectomía [8][9][10][11][12][13] . Sin embargo, hasta donde nuestro conocimiento alcanza, el presente es el primer caso de un adenocarcinoma de cuerpo y cola de páncreas asociado a GIST gástrico y a un hemangioma hepático cavernoso.…”

Section: Discussionunclassified

“…No existen grandes series publicadas de tumores pancreáticos malignos asociados a GIST gástricos. Todo lo que se ha publicado relativo a esta infrecuente asociación se encuentra como parte de grandes series de casos que estudian una variedad de tumores gastrointestinales malignos asociados a GIST en diferentes localizaciones [8][9][10] , o en algunos reportes de casos que discuten la presencia de tumores pancreáticos raros localizados en la cabeza del páncreas o en el proceso uncinado, todos ellos tratados mediante pancreatoduodenectomía [11][12][13] . No existen reportes publicados sobre adenocarcinoma de páncreas distal asociado a GIST gástrico del antro.…”

Section: Introductionunclassified

Manejo Quirúrgico Simultáneo De Una Paciente Con Cáncer De Páncreas Distal, Tumores Del Estroma Gastrointestinal (Gist) Gástricos Y Hemangioma Hepático

Valenzuela

Rodrı́guez

et al. 2014

Rev Chil Cir

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Simultaneous surgical management of a patient with distal pancreatic cancer, gastric gastrointestinal tumors (GIST) and hepatic hemangiomaIntroduction: The occurrence of gastric Gastrointestinal Stromal Tumors (GIST) associated to pancreatic adenocarcinoma has been reported in 0.2% pancreatic cancers. There are no published reports on distal pancreatic adenocarcinoma associated to gastric antral GIST and the surgical management of this clinical condition. Case report: Herein, we discuss a 75 years-old female patient who was admitted to our institution with upper digestive hemorrhage. The endoscopy showed large, superficial erosions over the cardia and on the posterior wall of the antrum a rounded sub-mucosal non-eroded lesion suspected of gastric GIST. An abdominal computed tomography scan found a hepatic hemangioma on the left hepatic lobe. In the pancreatic distal body and tail a solid exophytic lesion was identified. In the gastric antrum a rounded submucosal tumor in close contact with the pancreatic lesion was found. The patient was subjected to distal pancreatectomy, splenectomy, and distal gastrectomy. The biopsy identified a well-differentiated ductal adenocarcinoma localized in the pancreatic tail and the proximal part of the body, resected with negative margins. The gastric tumor was positive for CD117, CD34, and DOG-1; it had a positive Ki67 in less than 2%, and 2 or less mitoses per 50 high-power fields. Conclusion. This uncommon case illustrates the occurrence of synchronous tumors of different cellular origins incidentally diagnosed and their simultaneous surgical treatment. The individual incidence of these tumors is low and if associated they probably will continue to be found incidentally. ResumenIntroducción: La ocurrencia simultánea de tumores del estroma gastrointestinal (GIST) del estómago con cáncer de páncreas, ha sido reportada en 0,2%. No existen reportes publicados sobre cáncer de páncreas

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Multiple primary gastrointestinal tumors of gastric, pancreatic and rectal origin; a case report

Aloraini

Helmi

Aljomah

et al. 2021

International Journal of Surgery Case Reports

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Introduction The occurrence of multiple primary synchronous or metachronous malignancies is a described phenomenon. Such cases may have genetic predisposition or could be related to environmental risk factors but may also be sporadic. We are reporting a unique combination of triple primary synchronous malignancies in the same patient. Case presentation A 71 year old man presented with constipation and per rectal bleeding with a palpable mass 5–6 cm from the anal verge on physical examination. Colonoscopy with biopsy confirmed adenocarcinoma of rectal origin. After multi-disciplinary tumor board meeting, the patient received neoadjuvant chemoradiation therapy followed by single-stage surgery. Re-staging work up showed the presence of pancreatic lesion. Incidental finding of a gastric nodule upon surgical exploration which was confirmed to be a gastrointestinal stromal tumor. The patient had an uneventful postoperative course. Discussion Multiple primary malignancies of the gastrointestinal system has previously been reported in the literature; whether in the form of double, triple, quadruple or even quintuple primaries. Furthermore, gastrointestinal malignancies have been reported to be combined with extra-intestinal malignancies. However, this unique combination of pancreatic adenocarcinoma, rectal adenocarcinoma and gastric gastrointestinal stromal tumor has not been previously reported in the literature. Single-stage multiple resections was successful. Conclusion We are reporting a unique case of three primary malignancies involving the rectum, pancreas and stomach. For such patients, there is no clear guidelines regarding management or surveillance, but rather should be individualized.

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Synchronous Tumors: Adenosquamous Carcinoma of Pancreas and GIST of Stomach

Cited by 10 publications

References 6 publications

Adenosquamous carcinoma of the uncinate process of the pancreas with synchronous gastrointestinal stromal tumor of the stomach: Case report and review of the literature

Adenosquamous carcinoma of the uncinate process of the pancreas with synchronous gastrointestinal stromal tumor of the stomach: Case report and review of the literature

Manejo Quirúrgico Simultáneo De Una Paciente Con Cáncer De Páncreas Distal, Tumores Del Estroma Gastrointestinal (Gist) Gástricos Y Hemangioma Hepático

Multiple primary gastrointestinal tumors of gastric, pancreatic and rectal origin; a case report

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