Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012;3(9):463-6.
doi: 10.1016/j.ijscr.2012.03.030. Epub 2012 Apr 5.

Secondary recurrent multiple EGIST of the mesentary: A case report and review of the literature

Ilona D Goukassian  1 , S R Kussman, Y Toribio, Jennifer E Rosen
Affiliations

Secondary recurrent multiple EGIST of the mesentary: A case report and review of the literature

Ilona D Goukassian et al. Int J Surg Case Rep. 2012.

Abstract

Introduction: Gastrointestinal stromal tumors (GISTs) are rare intra-abdominal tumors arising from mesenchymal stromal cells. EGISTs are mesenchymal tumors that originate outside the GI tract and tend to have similar characteristics to GISTs. To the best of our knowledge, few cases of long standing recurrent EGIST have been reported.

Presentation of case: We present the case of a rare recurrent EGIST in the mesentery of a 39 year old female patient. The tumor was symptomatic at the time of complaint and measured 8.4cm×7.7cm×7.6cm. Histological analysis revealed a spindled pattern with fusiform cells arranged in long fascicles and little atypia. Immunochemistry showed positivity for CD117 and was negative for CD34, S-100, Desmin, and MSA. B-catenin was weakly positive. A Ki-67 staining shows approximately 5% positivity revealing a low proliferative rate. The patient was doing well postoperatively and was discharged on 400mg imanitib regimen.

Discussion: While GISTs are the most common tumors of the GI tract, recurrent EGISTs of the mesentery are extremely rare. Factors that indicate poor prognosis include tumor size greater than 5cm, mitotic rate greater than 1-5/10 HPF, presence of tumor necrosis or metastasis and most recently the c-kit mutation. Our patient had a very long time between recurrence of disease.

Conclusion: The current literature on EGISTs is limited. Our patient presents a very interesting case due to the time elapsed between disease recurrence and lack of metastasis or excessive growth.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
CT demonstrates cystic mass measuring 8.4 cm × 7.7 cm × 7.6 cm and an adjacent solid nodule enhancing the soft tissue measuring 2.9 cm × 1.2 cm.
Fig. 2
Fig. 2
EGIST abutting colonic wall showing no involvement of the colonic wall.
Fig. 3
Fig. 3
Immunohistochemical features of EGIST. Tumor cells characteristically express CD117 (A) and B-catenin (B) but Ki-67 stain shows low proliferative rate (C). A standard H&E stain of tumor cells is seen in (D).
Fig. 4
Fig. 4
EGIST abutting colonic wall.
See this image and copyright information in PMC

References

    1. Pidhorecky I., Cheney R.T., Kraybill W.G., Gibbs J.F. Gastrointestinal stromal tumors: current diagnosis, biologic behavior, and management. Annals of Surgical Oncology. 2000;7(October (9)):705–712. - PubMed
    1. Castillo-Sang M., Mancho S., Tsang A.W., Gociman B., Almaroof B., Ahmed M.Y. A malignant omental extra-gastrointestinal stromal tumor on a young man: a case report and review of the literature. World Journal of Surgical Oncology. 2008;6:50. - PMC - PubMed
    1. Reith J.D., Goldblum J.R., Lyles R.H., Weiss S.W. Extragastrointestinal (soft tissue) stromal tumors: an analysis of 48 cases with emphasis on histologic predictors of outcome. Modern Pathology. 2000;13(May (5)):577–585. - PubMed
    1. Agaimy A., Wuensch P.H. Gastrointestinal stromal tumours in patients with other-type cancer: a mere coincidence or an etiological association? A study of 97 GIST cases. Zeitschrift fur Gastroenterologie. 2005;43(September (9)):1025–1030. - PubMed
    1. Barros A., Linhares E., Valadao M., Goncalves R., Vilhena B., Gil C. Extragastrointestinal stromal tumors (EGIST): a series of case reports. Hepato-Gastroenterology. 2011;58(May–June (107–108)):865–868. - PubMed