Laparoscopic Resection of Sporadic Synchronous Gastric and Jejunal Gastrointestinal Stromal Tumors: Report of a Case

Overview

Journal Surg Today

Specialty General Surgery

Date 2009 Mar 26

PMID 19319643

Citations 7

Authors

Roberto DellAvanzato

Fabio Carboni

Maria Beatrice Palmieri

Raffaele Palmirotta

Fiorella Guadagni

Giovanna Pippa

Giuseppe Santeusanio

Mauro Antimi

Massimo Lopez

Massimo Carlini

Affiliations

Soon will be listed here.

Abstract

Multicentricity of gastrointestinal stromal tumors (GISTs) has been described only in patients with neurofibromatosis type 1 (NF1) or within the small intestine, and different pathogenetic mechanisms are involved. We report a case of synchronous sporadic gastric and jejunal GISTs, which were resected laparoscopically in a 67-year-old man. Immunohistochemical analysis revealed that both lesions were KIT (CD117)-positive, but that the gastric lesion was CD34-positive, whereas the jejunal one was Vimentin-, S-100-, and SMA-positive. Molecular analysis of mutations in KIT exons 9, 11, 13, and 17, and in PDGFRA exons 12 and 18 revealed the presence of a gastric sporadic GIST with a KIT mutation of the exon 11 and a jejunal sporadic GIST without KIT or PDGFRA mutations. To our knowledge, this is the first report of laparoscopically resected synchronous sporadic gastric and jejunal GISTs.

Citing Articles

Multiple Synchronous Sporadic Gastrointestinal Stromal Tumors in the Stomach and Jejunum.

Tokunaga M, Nanjo S, Yoshita H, Fujinami H, Watanabe T, Ishii Y Intern Med. 2018; 57(12):1719-1723.

PMID: 29434135 PMC: 6047988. DOI: 10.2169/internalmedicine.0229-17.

Simultaneous laparoscopy-assisted resection for rectal and gastric cancer.

Wei H, Master J, Chen T, Zheng Z, Wei B, Huang Y JSLS. 2014; 18(2):323-32.

PMID: 24960501 PMC: 4035648. DOI: 10.4293/108680813X13753907291350.

Gastrointestinal stromal tumors associated with neurofibromatosis 1: a single centre experience and systematic review of the literature including 252 cases.

Salvi P, Lorenzon L, Caterino S, Antolino L, Antonelli M, Balducci G Int J Surg Oncol. 2014; 2013:398570.

PMID: 24386562 PMC: 3872280. DOI: 10.1155/2013/398570.

Synchronous sporadic gastrointestinal stromal tumors in the stomach and jejunum: report of a case.

Nakayama Y, Kadowaki K, Higure A, Hisaoka M, Yamaguchi K Case Rep Gastroenterol. 2013; 7(1):69-74.

PMID: 23626506 PMC: 3617895. DOI: 10.1159/000348754.

Laparoscopic total gastrectomy for multiple sporadic gastric gastrointestinal stromal tumors: report of a case.

Fujimoto A, Kobayashi T, Uchida S, Ichinose Y, Sasaoki T, Goto K Surg Today. 2011; 42(1):84-8.

PMID: 22045229 DOI: 10.1007/s00595-011-0011-x.

References

Miettinen M, Lasota J . Gastrointestinal stromal tumors (GISTs): definition, occurrence, pathology, differential diagnosis and molecular genetics. Pol J Pathol. 2003; 54(1):3-24. View

Miettinen M, Makhlouf H, Sobin L, Lasota J . Gastrointestinal stromal tumors of the jejunum and ileum: a clinicopathologic, immunohistochemical, and molecular genetic study of 906 cases before imatinib with long-term follow-up. Am J Surg Pathol. 2006; 30(4):477-89. DOI: 10.1097/00000478-200604000-00008. View

Bucher P, Egger J, Gervaz P, Ris F, Weintraub D, Villiger P . An audit of surgical management of gastrointestinal stromal tumours (GIST). Eur J Surg Oncol. 2006; 32(3):310-4. DOI: 10.1016/j.ejso.2005.11.021. View

Pierie J, Choudry U, Muzikansky A, Yeap B, Souba W, Ott M . The effect of surgery and grade on outcome of gastrointestinal stromal tumors. Arch Surg. 2001; 136(4):383-9. DOI: 10.1001/archsurg.136.4.383. View

Lai I, Lee W, Yu S . Minimally invasive surgery for gastric stromal cell tumors: intermediate follow-up results. J Gastrointest Surg. 2006; 10(4):563-6. DOI: 10.1016/j.gassur.2005.08.028. View

Aparicio T, Boige V, Sabourin J, Crenn P, Ducreux M, Le Cesne A . Prognostic factors after surgery of primary resectable gastrointestinal stromal tumours. Eur J Surg Oncol. 2004; 30(10):1098-103. DOI: 10.1016/j.ejso.2004.06.016. View

Okubo K, Yamao K, Nakamura T, Tajika M, Sawaki A, Hara K . Endoscopic ultrasound-guided fine-needle aspiration biopsy for the diagnosis of gastrointestinal stromal tumors in the stomach. J Gastroenterol. 2004; 39(8):747-53. DOI: 10.1007/s00535-004-1383-0. View

Kindblom L, Remotti H, Aldenborg F, Meis-Kindblom J . Gastrointestinal pacemaker cell tumor (GIPACT): gastrointestinal stromal tumors show phenotypic characteristics of the interstitial cells of Cajal. Am J Pathol. 1998; 152(5):1259-69. PMC: 1858579. View

Mochizuki Y, Kodera Y, Fujiwara M, Ito S, Yamamura Y, Sawaki A . Laparoscopic wedge resection for gastrointestinal stromal tumors of the stomach: initial experience. Surg Today. 2006; 36(4):341-7. DOI: 10.1007/s00595-005-3164-7. View

10.

Hirota S, Isozaki K, Moriyama Y, Hashimoto K, Nishida T, Ishiguro S . Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science. 1998; 279(5350):577-80. DOI: 10.1126/science.279.5350.577. View

11.

Crosby J, Catton C, Davis A, Couture J, OSullivan B, Kandel R . Malignant gastrointestinal stromal tumors of the small intestine: a review of 50 cases from a prospective database. Ann Surg Oncol. 2001; 8(1):50-9. DOI: 10.1007/s10434-001-0050-4. View

12.

Gupta M, Sheppard B, Corless C, MacDonell K, Blanke C, Billingsley K . Outcome following surgical therapy for gastrointestinal stromal tumors. J Gastrointest Surg. 2006; 10(8):1099-105. DOI: 10.1016/j.gassur.2006.05.014. View

13.

Kontogianni K, Demonakou M, Kavantzas N, Lazaris A, Lariou K, Vourlakou C . Prognostic predictors of gastrointestinal stromal tumors: a multi-institutional analysis of 102 patients with definition of a prognostic index. Eur J Surg Oncol. 2003; 29(6):548-56. DOI: 10.1016/s0748-7983(03)00073-8. View

14.

Miettinen M, El-Rifai W, H L Sobin L, Lasota J . Evaluation of malignancy and prognosis of gastrointestinal stromal tumors: a review. Hum Pathol. 2002; 33(5):478-83. DOI: 10.1053/hupa.2002.124123. View

15.

Carboni F, Carlini M, Scardamaglia F, Santoro E, Boschetto A, Castelli M . Gastrointestinal stromal tumors of the stomach. A ten-year surgical experience. J Exp Clin Cancer Res. 2003; 22(3):379-84. View

16.

Kinoshita K, Isozaki K, Tsutsui S, Kitamura S, Hiraoka S, Watabe K . Endoscopic ultrasonography-guided fine needle aspiration biopsy in follow-up patients with gastrointestinal stromal tumours. Eur J Gastroenterol Hepatol. 2003; 15(11):1189-93. DOI: 10.1097/00042737-200311000-00007. View

17.

Heinrich M, Corless C, Demetri G, Blanke C, von Mehren M, Joensuu H . Kinase mutations and imatinib response in patients with metastatic gastrointestinal stromal tumor. J Clin Oncol. 2003; 21(23):4342-9. DOI: 10.1200/JCO.2003.04.190. View

18.

Otani Y, Kitajima M . Laparoscopic surgery for GIST: too soon to decide. Gastric Cancer. 2005; 8(3):135-6. DOI: 10.1007/s10120-005-0338-3. View

19.

Choi S, Kim M, Jung G, Kim H, Kwon H, Choi S . Laparoscopic wedge resection for gastric GIST: long-term follow-up results. Eur J Surg Oncol. 2006; 33(4):444-7. DOI: 10.1016/j.ejso.2006.11.003. View

20.

Duffaud F, Blay J . Gastrointestinal stromal tumors: biology and treatment. Oncology. 2003; 65(3):187-97. DOI: 10.1159/000074470. View