Metastatic gastrointestinal stromal tumor of the greater omentum. Case report
- Authors: Yugay V.V.1, Nikulin M.P.1,2, Mazurenko N.N.1, Mochal'nikova V.V.1, Filonenko D.A.3, Meshherjakov A.A.1, Bugaev V.E.1, Arhiri P.P.1,4, Stroganova A.M.1, Stilidi I.S.1,4,5
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Affiliations:
- Blokhin National Medical Research Center of Oncology
- Yevdokimov Moscow State University of Medicine and Dentistry
- Loginov Moscow Clinical Scientific Center
- Russian Medical Academy of Continuous Professional Education
- Pirogov Russian National Research Medical University
- Issue: Vol 23, No 4 (2021)
- Pages: 680-684
- Section: CLINICAL ONCOLOGY
- URL: https://journals.rcsi.science/1815-1434/article/view/76385
- DOI: https://doi.org/10.26442/18151434.2021.4.201222
- ID: 76385
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Abstract
Gastrointestinal stromal tumors (GIST) are the most common type of mesenchymal malignancies of the gastrointestinal (GI) tract. Almost 10% of them are originated outside of the GI tract (extra-GIST), while GIST of the greater omentum constitutes about 1% among stromal tumors. More than 80% of GIST have mutations in c-KIT and PDGFRA genes. Herein we demonstrate the case of successful treatment of patient with giant omental GIST with c-KIT exon 11 mutation. 64-years-old woman, was admitted to the Department of abdominal oncology with complaints of shortness of breath and abdominal enlargement in volume. CT-scan revealed a large tumor in the abdominal cavity with tumor size of 54×34×22 cm. The patient underwent left thoraco-abdominal approach. It was found that the tumor was originated from the greater omentum with several metastases located on the peritoneum of the left lateral channel. Resection of the large omentum, splenectomy, liver resection and was done. Postoperative immunohistochemical study showed the expression of CD117, CD34 in tumor cells. Ki-67 index was 12–15%. Genetic study revealed c-KIT exon 11 mutation. Treatment with imatinib 400 mg per day was started. Patient has been treated with imatinib for 12 years. On control examination we have found a metastasis in the anterior abdominal wall 3,5×3×2,5 cm in diameter. Afterwards we performed resection of anterior abdominal wall with metastasis on 9 November 2017. Immunohistochemical study confirmed metastasis of GIST. The index of tumor proliferation activity (Ki-67) was 45%. Patient prolonged imatinib treatment at the dose of 400 mg per day after operation. No signs of progression have been revealed on control examination 72 months after the operation. 12-year progression-free survival during imatinib treatment is unique in our practice. Moreover, in the case of further progression, we have second and third-line targeted therapy (sunitinib and regorafenib) and surgery treatment in local progression.
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##article.viewOnOriginalSite##About the authors
Vladimir V. Yugay
Blokhin National Medical Research Center of Oncology
Author for correspondence.
Email: yugay_vladimir@mail.ru
ORCID iD: 0000-0001-6169-2723
SPIN-code: 2271-3639
oncologist
Russian Federation, MoscowMaxim P. Nikulin
Blokhin National Medical Research Center of Oncology; Yevdokimov Moscow State University of Medicine and Dentistry
Email: yugay_vladimir@mail.ru
ORCID iD: 0000-0002-9608-4696
SPIN-code: 9455-5566
Cand. Sci. (Med.)
Russian Federation, MoscowNatalya N. Mazurenko
Blokhin National Medical Research Center of Oncology
Email: yugay_vladimir@mail.ru
ORCID iD: 0000-0003-4767-6983
SPIN-code: 9169-8910
D. Sci. (Biol.), Prof.
Russian Federation, MoscowValerija V. Mochal'nikova
Blokhin National Medical Research Center of Oncology
Email: yugay_vladimir@mail.ru
ORCID iD: 0000-0001-5275-7134
SPIN-code: 7131-1273
pathologist
Russian Federation, MoscowDar'ja A. Filonenko
Loginov Moscow Clinical Scientific Center
Email: yugay_vladimir@mail.ru
ORCID iD: 0000-0002-7224-3111
Cand. Sci. (Med.)
Russian Federation, MoscowAndrey A. Meshherjakov
Blokhin National Medical Research Center of Oncology
Email: yugay_vladimir@mail.ru
ORCID iD: 0000-0002-6009-653X
SPIN-code: 3987-0910
D. Sci. (Med.)
Russian Federation, MoscowVladislav E. Bugaev
Blokhin National Medical Research Center of Oncology
Email: yugay_vladimir@mail.ru
SPIN-code: 7913-4919
Cand. Sci. (Med.)
Russian Federation, MoscowPetr P. Arhiri
Blokhin National Medical Research Center of Oncology; Russian Medical Academy of Continuous Professional Education
Email: yugay_vladimir@mail.ru
ORCID iD: 0000-0002-6791-2923
SPIN-code: 6880-4902
Cand. Sci. (Med.)
Russian Federation, MoscowAnna M. Stroganova
Blokhin National Medical Research Center of Oncology
Email: yugay_vladimir@mail.ru
ORCID iD: 0000-0002-7297-5240
SPIN-code: 5295-3338
Cand. Sci. (Med.)
Russian Federation, MoscowIvan S. Stilidi
Blokhin National Medical Research Center of Oncology; Russian Medical Academy of Continuous Professional Education; Pirogov Russian National Research Medical University
Email: yugay_vladimir@mail.ru
ORCID iD: 0000-0002-0493-1166
SPIN-code: 9622-7106
D. Sci. (Med.), Prof., Acad. RAS
Russian Federation, MoscowReferences
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