Giant gastrointestinal stromal tumour of rare sarcomatoid epithelioid subtype:Case study and literature review

Gastrointestinal stromal tumours(GISTs) are the most common mesenchymal tumours of the gastrointestinal tract,but they represent less than 3% of all gastrointestinal tract malignancies.This is a detailed case study of a 52-yearold male patient treated for very uncommon histological subtype of gastri...

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Published inWorld journal of gastroenterology : WJG Vol. 21; no. 11; pp. 3388 - 3393
Main Authors Lech, Gustaw, Korcz, Wojciech, Kowalczyk, Emilia, Guzel, Tomasz, Radoch, Marcin, Krasnodębski, Ireneusz Wojciech
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Inc 21.03.2015
Subjects
Asymptomatic Diseases
Biomarkers, Tumor - analysis
Biopsy
Case Report
epithe
Epithelioid Cells - chemistry
Epithelioid Cells - pathology
Gastrectomy
Gastrointestinal
Gastrointestinal Stromal Tumors - chemistry
Gastrointestinal Stromal Tumors - pathology
Gastrointestinal Stromal Tumors - surgery
Humans
Immunohistochemistry
Male
Middle Aged
Predictive Value of Tests
Sarcoma - chemistry
Sarcoma - pathology
Sarcoma - surgery
Stomach Neoplasms - chemistry
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
stromal
Tomography, X-Ray Computed
Treatment Outcome
Tumor Burden
tumour;Sarcomatoid
Gastric gastrointestinal stromal tumour
Sarcomatoid epithelioid gastrointestinal stromal tumour
Gastrointestinal tract tumour
Gastrointestinal stromal tumour
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Summary:Gastrointestinal stromal tumours(GISTs) are the most common mesenchymal tumours of the gastrointestinal tract,but they represent less than 3% of all gastrointestinal tract malignancies.This is a detailed case study of a 52-yearold male patient treated for very uncommon histological subtype of gastric GIST with atypical clinical presentation,asymptomatic progress and late diagnosis.The resected tumour,giant in diameters,was confirmed to represent the most rare histopathologic subtype of GISTs- sarcomatoid epithelioid GIST.We report this case and review the literature with a special focus on pathomorphological evaluation,biological aggressiveness and prognostic factors.To our knowledge this is the first report of giant GIST of very uncommon sarcomatoid epithelioid subtype.It is concluded that clinicians should pay attention to the fact that initial diagnosis may be delayed due to mildly asymptomatic and non-specific clinical presentation.Asymptomatic tumours diagnosed at a late stage,which is often the case,can be large on presentation.Prognosis for patients diagnosed with GIST depend on tumour size,mitotic rate,histopathologic subtype and tumour location.That is why early diagnosis and R0 resection,which is usually feasible and safe even in giant gastric sarcomatoid epithelioid subtype of GISTs,are the key factors for further treatment and good prognosis.
Bibliography:Gastrointestinal stromal tumour;Sarcomatoid epithe
Gastrointestinal stromal tumours(GISTs) are the most common mesenchymal tumours of the gastrointestinal tract,but they represent less than 3% of all gastrointestinal tract malignancies.This is a detailed case study of a 52-yearold male patient treated for very uncommon histological subtype of gastric GIST with atypical clinical presentation,asymptomatic progress and late diagnosis.The resected tumour,giant in diameters,was confirmed to represent the most rare histopathologic subtype of GISTs- sarcomatoid epithelioid GIST.We report this case and review the literature with a special focus on pathomorphological evaluation,biological aggressiveness and prognostic factors.To our knowledge this is the first report of giant GIST of very uncommon sarcomatoid epithelioid subtype.It is concluded that clinicians should pay attention to the fact that initial diagnosis may be delayed due to mildly asymptomatic and non-specific clinical presentation.Asymptomatic tumours diagnosed at a late stage,which is often the case,can be large on presentation.Prognosis for patients diagnosed with GIST depend on tumour size,mitotic rate,histopathologic subtype and tumour location.That is why early diagnosis and R0 resection,which is usually feasible and safe even in giant gastric sarcomatoid epithelioid subtype of GISTs,are the key factors for further treatment and good prognosis.
Gustaw Lech;Wojciech Korcz;Emilia Kowalczyk;Tomasz Guzel;Marcin Radoch;Ireneusz Wojciech Krasnodebski;Department of General,Gastroenterological and Oncological Surgery,Medical University of Warsaw;Students’ Scientific Group at Department of General,Gastroenterological and Oncological Surgery,Medical University of Warsaw
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SourceType-Scholarly Journals-1
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ObjectType-Feature-5
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Telephone: +48-22-5992482 Fax: +48-22-5992057
Correspondence to: Gustaw Lech, MD, PhD, Department of General, Gastroenterological and Oncological Surgery, Medical University of Warsaw, Banacha 1a, 02091 Warsaw, Poland. gustaw.lech@wum.edu.pl
Author contributions: Lech G wrote the manuscript and provided the original pictures; Korcz W wrote the manuscript; Kowalczyk E and Radoch M collected the clinical and radiological data; Guzel T and Krasnodębski IW reviewed the manuscript.
ISSN:1007-9327
2219-2840
DOI:10.3748/wjg.v21.i11.3388