Subsequent intra-abdominal fibromatosis mimicking recurrent gastrointestinal stromal tumor

• Published in: Diagnostic pathology Vol. 8; no. 1; p. 125
• Main Authors: Jiang, Dongxian, He, Deming, Hou, Yingyong, Lu, Weiqi, Shi, Yuan, Hu, Qin, Lu, Shaohua, Xu, Chen, Liu, Yalan, Liu, Ju, Tan, Yunshan, Zhu, Xiongzeng
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 31.07.2013; BioMed Central
• Subjects: Abdomen; Antineoplastic Agents - therapeutic use; Benzamides - therapeutic use; Care and treatment; Case Report; Case studies; Complications and side effects; Diagnostic Errors; Digestive System Surgical Procedures - adverse effects; Disease; Diseases; Duodenal Neoplasms - complications; Duodenal Neoplasms - pathology; Duodenal Neoplasms - surgery; Fibromas; Fibromatosis, Abdominal - diagnosis; Fibromatosis, Abdominal - etiology; Fibromatosis, Abdominal - surgery; Gastrointestinal Stromal Tumors - complications; Gastrointestinal Stromal Tumors - pathology; Gastrointestinal Stromal Tumors - surgery; Hospitals; Humans; Imatinib Mesylate; Jejunal Neoplasms - complications; Jejunal Neoplasms - pathology; Jejunal Neoplasms - surgery; Male; Middle Aged; Mutation; Neoplasm Recurrence, Local; Pathology; Piperazines - therapeutic use; Predictive Value of Tests; Pyrimidines - therapeutic use; Relapse; Reoperation; Risk Factors; Smooth muscle; Surgery; Tomography; Tomography, X-Ray Computed; Treatment Outcome; Tumor Burden; Tumors; Unnecessary Procedures; Denmark
• ISSN: 1746-1596; 1746-1596
• DOI: 10.1186/1746-1596-8-125

Intra-abdominal fibromatosis (IAF) commonly develops in patients who had abdominal surgery. In rare instances, it occurs subsequent to gastrointestinal stromal tumor (GIST). This special situation has clinical significance in imatinib era. About 1000 patients with GIST in our institution from 1993 to 2010 were re-evaluated based on their clinical and pathological data, the treatment strategies and the follow-up information. We identified 2 patients who developed IAF after GIST resection. Patient 1 was a 54 year-old male and had 5 cm × 4.5 cm × 3.5 cm jejunal GIST excised on February 22, 1994. Three years later, an abdominal mass with 7 cm × 6 cm × 3 cm was identified. He was diagnosed as recurrent GIST from clinical point of view. After excision, the second tumor was confirmed to be IAF. Patient 2 was a 45-year-old male and had 6 cm × 4 cm × 3 cm duodenal GIST excised on August 19, 2008. One year later, a 4 cm mass was found at the original surgical site. The patient refused to take imatinib until the tumor increased to 8 cm six months later. The tumor continued to increase after 6 months' imatinib therapy, decision of surgical resection was made by multidisciplinary team. The second tumor was confirmed to be IAF with size of 17 cm × 13 cm × 11 cm. Although IAF subsequent to GIST is very rare, it is of clinical significance in imatinib era as an influencing factor for making clinical decision. The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1076715989961803.