Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
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Gastrointestinal Stromal Tumor with Extensive Lymphatic Metastasis: A Case Report

  • Kang, Ki Young (Department of Anatomy, Seonam University College of Medicine) ;
  • Lee, Woong (Department of Surgery, Seonam University College of Medicine)
  • Received : 2013.07.08
  • Accepted : 2013.08.02
  • Published : 2013.09.30
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Abstract

Gastrointestinal stromal tumor is a rare tumor which arises from the whole gastrointestinal tracts and most of it is detected in the stomach. It is uncommon with small intestine originated gastrointestinal stromal tumor and more uncommon with lymphatic metastasis. We experienced an unusual case of the small bowel gastrointestinal stromal tumor during experimental autopsy. Two primary tumors with central necrosis were detected in the ileum. The sizes of each tumor were $6.1{\times}3.4{\times}4.0$ cm and $3.7{\times}4.2{\times}3.2$ cm. There was extensive lymphatic metastasis on the greater omentum and mesenteric, iliac lymph nodes were also involved. With histologic findings, the eosinophilic spindle cells were densely distributed. Immunohistochemical findings were CD117 (-), CD34 (+), desmin (-), and S-100 protein (-). Therefore, we diagnosed the tumors as small bowel gastrointestinal stromal tumors with broad lymph node mestasis.

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References

  1. Sircar K, Hewlett BR, Huizinga JD, Chorneyko K, Berezin I, Riddell RH. Interstitial cells of Cajal as precursors of gastrointestinal stromal tumors. Am J Surg Pathol 1999;23:377-389. https://doi.org/10.1097/00000478-199904000-00002
  2. Rubin BP, Singer S, Tsao C, Duensing A, Lux ML, Ruiz R, et al. KIT activation is a ubiquitous feature of gastrointestinal stromal tumors. Cancer Res 2001;61:8118-8121.
  3. Kim CJ, Day S, Yeh KA. Gastrointestinal stromal tumors: analysis of clinical and pathologic factors. Am Surg 2001;67:135-137.
  4. Kim EK, Lee HC, Lee MR, Lim SB, Kang SB, Park KJ, et al. Gastrointestinal stromal tumors (GISTs) of the colon and rectum: clinicopathological analysis. J Korean Soc Coloproctol 2003;19:282-289.
  5. Eisenberg BL, Judson I. Surgery and imatinib in the management of GIST: emerging approaches to adjuvant and neoadjuvant therapy. Review Ann Surg Oncol 2004;11:465-475. https://doi.org/10.1245/ASO.2004.09.011
  6. Miettinen M, Sarlomo-rikala M, Lasota J. Gastrointestinal stromal tumors: recent advances in understanding of their biology. Hum Pathol 1999;30:1213-1220. https://doi.org/10.1016/S0046-8177(99)90040-0
  7. Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 18th ed. Philadelphia: Saunders Elsevier, 2008:1271-1272.
  8. Pidhorecky I, Cheney RT, Kraybill WG, Gibbs JF. Gastrointestinal stromal tumors: current diagnosis, biologic behavior, and management. Ann Surg Oncol 2000;7:705-712. https://doi.org/10.1007/s10434-000-0705-6
  9. Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, et al. Diagnosis of gastrointestinal stromal tumors: a consensus approach. Hum Pathol 2002;33:459-465. https://doi.org/10.1053/hupa.2002.123545
  10. Hirota S, Isozaki K. Pathology of gastrointestinal stromal tumors. Pathol Int 2006;56:1-9. https://doi.org/10.1111/j.1440-1827.2006.01924.x
  11. Howe JR, Karnell LH, Scott-conner C. Small bowel sarcoma: analysis of survival from the National Cancer Data Base. Ann Surg Oncol 2001;8:496-508. https://doi.org/10.1007/s10434-001-0496-4
  12. Heo GW, Shin DW, Paik SY, Kim ID, Kim KH, Suh BS, et al. Comparative study of the clinicopathologic characteristics between gastrointestinal stromal tumors arising from the stomach and small bowel. J Korean Gastric Cancer Assoc 2007;7:254-260. https://doi.org/10.5230/jkgca.2007.7.4.254
  13. Morinaga N, Sano A, Katayama K, Suzuki K, Kamisaka K, Asao T, et al. Laparoscopic transgastric tumor-everting resection of the gastric submucosal tumor located near the esophagogastric junction. Surg Laparosc Endosc Percutan Tech 2004;14:344-348. https://doi.org/10.1097/01.sle.0000148467.33437.c4
  14. Pross M, Manger T, Schulz HU, Lippert H, Roessner A, Günther T. Gastrointestinal stromal tumors--problems in diagnosis and therapy. Chirurg 1999;70:807-812. https://doi.org/10.1007/s001040050728