Gastrointestinal stromal tumor of unusual location
Keywords:
adrenal gland neoplasms; case reports; colon, transverse; gastrointestinal stromal tumors; tomography; ultrasonographyAbstract
Introduction: Gastrointestinal stromal tumors (GISTs) are rare mesenchymal lesions, with an incidence of less than 1% in the colon.
Objective: To present the case of a GIST in an unusual location in the transverse colon.
Clinical Case: A 62-year-old male patient with a history of essential hypertension presented with changes in bowel habits and an acute, nonspecific febrile syndrome. Physical examination revealed a palpable tumor in the right hypochondrium and flank. Imaging studies identified a heterogeneous exophytic tumor in the transverse colon and another mass in the right adrenal gland, suggesting a colon neoplasm with metastasis. During laparotomy, a 15-cm tumor was found adherent to adjacent structures, and an extended right hemicolectomy was performed. An excisional biopsy of the adrenal lesion was performed, and the analysis confirmed GIST metastasis. The histopathological and immunohistochemical study of the colonic specimen (CD117 and DOG1 positive) confirmed the diagnosis of GIST.
Conclusions: The diagnosis of colonic GISTs with adrenal metastasis requires a high index of suspicion and a multidisciplinary approach. This case emphasizes the rarity of colonic involvement and the importance of surgery as a cornerstone of treatment.
Downloads
References
1. 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 [Internet]. Science. 1998;279(5350):577-80. DOI: 10.1126/science.279.5350.577
2. Miettinen M, Lasota J. Histopathology of gastrointestinal stromal tumor [Internet]. J Surg Oncol. 2011;104(8):865-73. DOI: 10.1002/jso.21945
3. Søreide K, Sandvik OM, Søreide JA, Giljaca V, Jureckova A, Bulusu VR. Global epidemiology of gastrointestinal stromal tumours (GIST): A systematic review of population-based cohort studies [Internet]. Cancer Epidemiol. 2016;40:39-46. DOI: 10.1016/j.canep.2015.10.031
4. Miettinen M, Furlong M, Sarlomo-Rikala M, Burke A, Sobin LH, Lasota J. Gastrointestinal stromal tumors, intramural leiomyomas, and leiomyosarcomas in the rectum and anus: a clinicopathologic, immunohistochemical, and molecular genetic study of 144 cases [Internet]. Am J Surg Pathol. 2001;25(9):1121-33. DOI: 10.1097/00000478-200109000-00002
5. Casali PG, Blay JY, Abecassis N, Bajpai J, Bauer S, Biagini R, et al. Gastrointestinal stromal tumours: ESMO-EURACAN-GENTURIS Clinical Practice Guidelines for diagnosis, treatment and follow-up [Internet]. Ann Oncol. 2022;33(1):20-33. DOI: 10.1016/j.annonc.2021.09.005
6. Miettinen M, Wang ZF, Lasota J. DOG1 antibody in the differential diagnosis of gastrointestinal stromal tumors: a study of 1840 cases [Internet]. Am J Surg Pathol. 2009;33(9):1401-8. DOI: 10.1097/PAS.0b013e3181a90e1a
7. Novelli M, Rossi S, Rodriguez-Justo M, Taniere P, Seddon B, Toffolatti L, et al. DOG1 and CD117 are the antibodies of choice in the diagnosis of gastrointestinal stromal tumours [Internet]. Histopathology. 2010;57(2):259-70. DOI: 10.1111/j.1365-2559.2010.03624.x
8. Alafifi M, Doumer A, Abdi EM, Safieddine M, Moataz A, Dakir M, et al. What may an adrenal mass conceal? Adrenal gastrointestinal stromal tumor: a case report [Internet]. J Surg Case Rep. 2024;2024(4):rjae229. DOI: 10.1093/jscr/rjae229
9. Rasheed MW, Afolayan EA, Uchechukwu BE, Idowu NA, Kabiru A, Adegboye TA, et al. Clinicopathological and immunohistochemical characterization of gastrointestinal stromal tumour at four tertiary health centers in Nigeria using CD117, DOG1, and human epidermal growth factor receptor-2 biomarkers [Internet]. Ann Afr Med. 2023;22(4):501-7. DOI: 10.4103/aam.aam_180_22
10. Joensuu H. Risk stratification of patients diagnosed with gastrointestinal stromal tumor [Internet]. Hum Pathol. 2008;39(10):1411-9. DOI: 10.1016/j.humpath.2008.06.025
11. Demetri GD, von Mehren M, Jones RL, Besmer P, Reichardt P, Trent J, et al. Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors [Internet]. N Engl J Med. 2002;347(7):472-80. DOI: 10.1056/NEJMOA020461
12. von Mehren M, Kane JM, Riedel RF, Sicklick JK, Pollack SM, et al. NCCN Guidelines® Insights: Gastrointestinal Stromal Tumors, Version 2.2022 [Internet]. J Natl Compr Canc Netw. 2022;20(11):1204-14. DOI: 10.6004/jnccn.2022.0058
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 María del Carmen Díaz de Armas, Mayara Figueroa Domínguez, Oriol Alfonso Moya, Diamara Rodríguez Perez, Lisneybi González González, Junior Vega Jiménez
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who have publications with this Journal accept the following terms:
- The authors will retain their copyright and guarantee the Journal the right of first publication of their work, which will simultaneously be subject to the Creative Commons Attribution License. The content presented here can be shared, copied and redistributed in any medium or format; Can be adapted, remixed, transformed or created from the material, using the following terms: Attribution (giving appropriate credit to the work, providing a link to the license, and indicating if changes have been made); non-commercial (you cannot use the material for commercial purposes) and share-alike (if you remix, transform or create new material from this work, you can distribute your contribution as long as you use the same license as the original work).
- The authors may adopt other non-exclusive license agreements for the distribution of the published version of the work (for example: depositing it in an institutional electronic archive or publishing it in a monographic volume) as long as the initial publication in this Journal is indicated.
- Authors are allowed and recommended to disseminate their work through the Internet (e.g., in institutional electronic archives or on their website) before and during the submission process, which can produce interesting exchanges and increase citations. of the published work.
