2007, Number 1
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Cir Gen 2007; 29 (1)
Gastrointestinal stromal tumors. Presentation of a series of three cases with gastric location
Pérez MAG, Ruiz JI, Roesch DF, Martínez FS, Martínez JA
Language: Spanish
References: 31
Page: 50-53
PDF size: 135.95 Kb.
ABSTRACT
Gastrointestinal stromal tumors are an uncommon entity. They differentiate from other mesenchymal tumors of the gastrointestinal tract through immunohistochemical studies performed with KIT (CD 117). These studies have allowed for a better understanding of their biology and the involved genetic mechanisms. Their clinical detection and timely treatment are utterly important because 10 to 30% of them produce hepatic metastases and peritoneal implants, which, aside from the surgical treatment, require molecular targeted therapies, such as the use of selective inhibitors of tyrosine-kinase (imatinib mesylate). The use of the latter has allowed reaching a 5-year survival of 43% in patients with metastasic disease.
We present a series of three cases of stromal tumors located gastrically and cared for at the “Hospital Español” in the city of Veracruz, Veracruz State, Mexico. We analyzed the results of the morphological studies and the used therapy. We found a tight familial relation in two of them.
REFERENCES
Meissner WA. Arch Pathol 1994; 38: 207. As quoted. In: Morson BC, Dawson IMP. Gastrointestinal pathology. Blackwell scientific publications. Osney Meadm Oxford 1972: 162..
Herrera GA, Cerezo L, Jones JE, Sack J, Grizzle WE, Pollack WJ, et al. Gastrointestinal autonomic nerve tumors “Plexosarcomas”. Arch Pathol Lab Med 1989; 113: 846-853.
Kindblom LG, Remotti HE, Aldenborq F, Meis-Kindblom JM. Gastrointestinal pacemaker cell tumor (GIPACT): gastrointestinal stromal tumors show phenotypic characteristics of the interstitial cell of Cajal. Am J Pathol 1998; 152: 1259-1269.
Appelman HD, Helwig EB. Gastric epithelioid leiomyoma and leiomyosarcoma (leiomyoblastoma). Cancer 1976; 38: 708-28.
Diamond T, Danton MH, Parks TG. Smooth muscle tumors of the alimentary tract. Ann R Coll Surg Engl 1990; 72: 316-20.
Miettinen M, Sarlomo-Rikala M, Lasota J. Gastrointestinal stromal tumors: recent advances in understanding of their biology. Hum Pathol 1999; 30: 1213-20.
Rubín BP, Fletcher JA, Fletcher CD. Molecular insights into the histogenesis and pathogenesis of gastrointestinal stromal tumors. Int J Surg Pathol 2000; 8: 5-10.
Miettinen M, Lasota J. Gastrointestinal stromal tumors—definition, clinical histological, immunohistochemical, and molecular genetic features and differential diagnosis. Virchows Arch 2001; 438: 1-12.
Lux M, Rubin BP, Biase TL, Chen CJ, Maclure T, Demetri G, et al. KIT extracellular and kinase domain mutations in gastrointestinal stromal tumors. Am J Pathol 2000; 156: 791-795.
Pidhorecky J, Cheney RT, Kraybill WG, Gibbs JF. Gastrointestinal stromal tumors: current diagnosis, biologic behavior, and management. Ann Surg Oncol 2000; 7: 705-712.
Levy A, Remotti H, Thompson WM, Sobin LH, Miettinen M. Gastrointestinal stromal tumors: radiologic features with pathologic correlation. Radiographics 2003; 23: 283-304.
Tran T, Davila JA, El-Seraq HB. The epidemiology of malignant gastrointestinal stromal tumors: an analysis of 1,458 cases from 1992 to 2000. Am J Gastroenterol 2005; 100: 162-168.
Miettinen M, Sobin LH, Lasota J. Gastrointestinal stromal tumors of the stomach: a clinicopathologic, immunohistochemical, and molecular genetic study of 1765 cases with long-term follow-up. Am J Surg Pathol 2005; 167: 52-68.
Fletcher CD, Berman JJ, Corless C, Gornstein F, Lasota J, Longley J, et al. Diagnosis of gastrointestinal stromal tumors: A consensus approach. Hum Pathol 2002; 33: 459-465.
Pérez EA, Livingstone AS, Franceschi D, Rocha-Lima C, Lee DJ, Hodgson N, et al. Current incidence and outcomes of gastrointestinal mesenchymal tumors including gastrointestinal stromal tumors. J Am Coll Surg 2006; 202: 623-629.
Nilson B, Bumming P, Meis-Kindblom JM, Oden A, Gustavsson B, Sablinska K, et al. Gastrointestinal stromal tumors: the incidence, prevalence, clinical course and prognostication in the preimatinib mesylate era –a population-based study in western Sweden. Cancer 2005; 103: 821-829.
Connolly EM, Gaffney E, Reynolds JV. Gastrointestinal stromal tumors. Br J Surg 2003; 90: 1178-1183.
Roberts PJ, Eisenberg B. Clinical presentation of gastrointestinal stromal tumors and treatment of operable disease. Eur J Cancer 2002; 38 Suppl 5: S37-8.
Erazo VA. Reto diagnóstico y opciones terapéuticas de los tumores estromales del aparato digestivo. Gaceta Mex Oncol 2005; 4 Supl. 1: 10-13.
Hirota S, Isozaki K, Moriyama Y, Hashimoto K, Nishida T, Ishiguro S, et al. Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science 1998; 279: 577-580.
Lux M., Rubin BP, Biase TL. Chen CJ, Maclure T Demetri G, et al. KIT extracellular and kinase domain mutations in gastrointestinal stromal tumors. Am J Pathol 2000; 156: 791-795.
Antonescu CR, Viale A, Serran L, Tschernyavsky SJ, Gonen M, Segal NH, et al. Gene expression in gastrointestinal tumors is distinguished by KIT genotype and anatomic site. Clin Cancer Res 2004; 10: 3282-3290.
Rossi CR, Mocellin S, Mencarelli R, Foletto M, Pilati P, Nitti D, et al. Gastrointestinal stromal tumors: from a surgical to a molecular approach. Int J Cancer 2003; 107: 171-176.
Wu PC, Langerman A, Ryan CW, Hart J, Swiger S, Posner MC. Surgical treatment of gastrointestinal stromal tumors in the imatinib (STI-571 era. Surgery 2003; 134: 656-666.
Eisenberg BL, Judson I. Surgery and imatinib in the management of GIST: emerging approaches to adjuvant and neoadjuvant therapy. Ann Surg Oncol 2004; 11: 465-475.
Joensuu H, Roberts PJ, Sarlomo-Rikala M, Andersson LC, Tervahartiala P, Tuveson D, et al. Effect of the tyrosin kinase inhibitor STI 571 in a patient with metastatic gastrointestinal stromal tumor. N Engl J Med 2001; 344: 1052-1056.
Dematteo RP, Maki RG, Antonescu C, Brennan MF. Targeted molecular therapy for cancer: the application of STI571 to gastrointestinal stromal tumor. Curr Probl Surg 2003; 40: 144-193.
Patel SR. La era de la terapia molecular: Redefiniendo el tratamiento de los tumores del estroma intestinal. Gaceta Mex Oncol 2005; 4: 13-17.
Demetri GD, von Mehren M, Blanke CD, Van den Abbeele AD, Eisenberg B, Roberts PJ, et al. Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med 2002; 347: 472-480.
Stroobants S, Goeminne J, Seegers M, Dimitrijevic S, Dupont P, Nuyts J, et al. 18FDG-Positron emission tomography for the early prediction of response in advance soft tissue sarcoma treated with imatinib mesylate (Glivec). Eur J Cancer 2003; 39: 2012-2020.
Van Glabbeke M, Verweij J, Casali PG, Simes J, Le Cesne A, Reichardt P, et al. Predicting toxicities for patients with advanced gastrointestinal stromal tumours treated with imatinib: a study of the European Organization for Research and Treatment of Cancer, the Italian Sarcoma Group, and the Australasian Gastro-Intestinal Trials Group (EORTC-ISG-AGITG). Eur J Cancer 2006; 42: 2277-85.