Extra Gastrointestinal Stromal Tumour (EGIST) of Chest Wall Detected on 18 F-FDG PET/CT: A Case Report and Brief Review of Literature
,
Abstract
Gastrointestinal stromal tumors (GIST) are rare tumors accounting for less than 1% of primary neoplasia of the digestive tract. They can also occur outside the GIT, where they are called extra gastrointestinal stromal tumors (EGIST), which are extremely rare tumors. GISTS and EGISTS have similar histo-pathological and molecular profiles. Though these are known to be FDG avid, some of the atypical GISTS can be FDG negative or only minimally FDG avid.Here, an unusual case of a 57-year-old female with FDG avid solitary chest wall mass is presented, which after biopsy and immune-histochemistry was proven as EGIST. She underwent en block resection of the tumor and is presently on adjuvant treatment with Imatinib mesylate. This case report highlights the importance of considering EGIST as a differential diagnosis of a solitary chest wall mass and the utility of 18F- FDG PET/CT in its management.
[1] Yi JH, Park BB, Kang JH, Hwang IG, Shin DB, Sym SJ, et al. Retrospective analysis of extra-gastrointestinal stromal tumors. World J Gastroenterol 2015; 21(6):1845-50. https://doi.org/10.3748/wjg.v21.i6.1845
[2] Dorfman DM, Bui MM, Tubbs RR, Hsi ED, Fitzgibbons PL, Linden MD, et al. The CD117 immunohistochemistry tissue microarray survey for quality assurance and interlaboratory comparison: a College of American Pathologists Cell Markers Committee Study. Arch Pathol Lab Med 2006; 130(6):779-82. https://doi. org/10.5858/2006-130-779-TCITMS
[3] You YH, Zhang Y. Primary prostatic extragastrointestinal stromal tumor: a case report and literature review. J Int Med Res 2018; 46(10):4343-49. https://doi.org/10.1177/0300060518791677
[4] Barros A, Linhares E, Valadão M, Gonçalves R, Vilhena B, Gil C, Ramos C. Extragastrointestinal stromal tumors (EGIST): a series of case reports. Hepatogastroenterology 2011; 58(107- 108):865-68.
[5] Long KB, Butrynski JE, Blank SD, Ebrahim KS, Dressel DM, Heinrich MC, et al. Primary extragastrointestinal stromal tumor of the pleura: report of a unique case with genetic confirmation. Am J Surg Pathol 2010; 34(6):907-12. https://doi. org/10.1097/PAS.0b013e3181d9f18f
[6] Lee JR, Anstadt MP, Khwaja S, Green LK. Gastrointestinal stromal tumor of the posterior mediastinum. Eur J Cardiothorac Surg 2002; 22:1014-16. https://doi.org/10.1016/S1010- 7940(02)00568-7
[7] Kamiyama Y, Aihara R, Nakabayashi T, Mochiki E, Asao T, Kuwano H, et al. 18F-fluorodeoxyglucose positron emission
tomography: useful technique for predicting malignant potential of gastrointestinal stromal tumors. World J Surg 2005; 29:1429-35. https://doi.org/10.1007/s00268-005-0045-6
[8]Kalkmann J, Zeile M, Antoch G, Berger F, Diederich S, Dinter D, et al. Consensus report on the radiological management of patients with gastrointestinal stromal tumours (GIST): recommendations of the German GIST Imaging Working Group. Cancer Imaging 2012; 12:126-35. https://doi. org/10.1102/1470-7330.2012.0013
[9]Gayed I, Vu T, Iyer R, Johnson M, Macapinlac H, Swanston N, et al. The role of 18F-FDG PET in staging and early prediction of response to therapy of recurrent gastrointestinal stromal tumors. J Nucl Med 2004; 45:17-21.
[10] Park JW, Cho CH, Jeong DS, Chae HD: Role of F-fluoro-2- deoxyglucose positron emission tomography in gastric GIST: predicting malignant potential pre-operatively. J Gastric Cancer 2011; 11:173-79. https://doi.org/10.5230/jgc.2011.11.3.173
[11] Choi H, Charnsangavej C, de Castro Faria S, Tamm EP, Benjamin RS, Johnson MM, et al. CT evaluation of the response of gastrointestinal stromal tumors after imatinib mesylate treatment: a quantitative analysis correlated with FDG PET findings. Am J Roentgenol 2004; 183:1619-28. https://doi. org/10.2214/ajr.183.6.01831619[12] Stroobants S, Goeminne J, Seegers M, Dimitrijevic S, Dupont P, Nuyts J, et al. 18FDG-Positron emission tomography for the early prediction of response in advanced soft tissue sarcoma treated with imatinib mesylate (Glivec). Eur J Cancer 2003; 39:2012-20. https://doi.org/10.1016/S0959-8049(03)00073-X
[13] Lim J, Cho SW, Lee HS, Kim HS, Kim YH, Park BS. Extra- Gastrointestinal Stromal Tumor Presenting as an Anterior Chest Wall Mass. Korean J Thorac Cardiovasc Surg 2017; 50(4):308- 11. https://doi.org/10.5090/kjtcs.2017.50.4.308
[14] Williams A, Gutzeit A, Germer M, Pless M: PET-Negative Gastrointestinal Stromal Tumors. Case Rep Oncol 2013; 6:508-13. https://doi.org/10.1159/000355432
[15] Schaefer IM, Mariño-Enríquez A, Fletcher JA. What is New in Gastrointestinal Stromal Tumor?. Adv Anat Pathol 2017; 24(5):259-67. https://doi.org/10.1097/ PAP.0000000000000158
[16] Demetri GD, von Mehren M, Antonescu CR, DeMatteo RP, Ganjoo KN, Maki RG, et al. NCCN Task Force report: update on the management of patients with gastrointestinal stromal tumors. J Natl Compr Canc Netw 2010; 8(suppl 2):S1-S44. https://doi.org/10.6004/jnccn.2010.0116
[2] Dorfman DM, Bui MM, Tubbs RR, Hsi ED, Fitzgibbons PL, Linden MD, et al. The CD117 immunohistochemistry tissue microarray survey for quality assurance and interlaboratory comparison: a College of American Pathologists Cell Markers Committee Study. Arch Pathol Lab Med 2006; 130(6):779-82. https://doi. org/10.5858/2006-130-779-TCITMS
[3] You YH, Zhang Y. Primary prostatic extragastrointestinal stromal tumor: a case report and literature review. J Int Med Res 2018; 46(10):4343-49. https://doi.org/10.1177/0300060518791677
[4] Barros A, Linhares E, Valadão M, Gonçalves R, Vilhena B, Gil C, Ramos C. Extragastrointestinal stromal tumors (EGIST): a series of case reports. Hepatogastroenterology 2011; 58(107- 108):865-68.
[5] Long KB, Butrynski JE, Blank SD, Ebrahim KS, Dressel DM, Heinrich MC, et al. Primary extragastrointestinal stromal tumor of the pleura: report of a unique case with genetic confirmation. Am J Surg Pathol 2010; 34(6):907-12. https://doi. org/10.1097/PAS.0b013e3181d9f18f
[6] Lee JR, Anstadt MP, Khwaja S, Green LK. Gastrointestinal stromal tumor of the posterior mediastinum. Eur J Cardiothorac Surg 2002; 22:1014-16. https://doi.org/10.1016/S1010- 7940(02)00568-7
[7] Kamiyama Y, Aihara R, Nakabayashi T, Mochiki E, Asao T, Kuwano H, et al. 18F-fluorodeoxyglucose positron emission
tomography: useful technique for predicting malignant potential of gastrointestinal stromal tumors. World J Surg 2005; 29:1429-35. https://doi.org/10.1007/s00268-005-0045-6
[8]Kalkmann J, Zeile M, Antoch G, Berger F, Diederich S, Dinter D, et al. Consensus report on the radiological management of patients with gastrointestinal stromal tumours (GIST): recommendations of the German GIST Imaging Working Group. Cancer Imaging 2012; 12:126-35. https://doi. org/10.1102/1470-7330.2012.0013
[9]Gayed I, Vu T, Iyer R, Johnson M, Macapinlac H, Swanston N, et al. The role of 18F-FDG PET in staging and early prediction of response to therapy of recurrent gastrointestinal stromal tumors. J Nucl Med 2004; 45:17-21.
[10] Park JW, Cho CH, Jeong DS, Chae HD: Role of F-fluoro-2- deoxyglucose positron emission tomography in gastric GIST: predicting malignant potential pre-operatively. J Gastric Cancer 2011; 11:173-79. https://doi.org/10.5230/jgc.2011.11.3.173
[11] Choi H, Charnsangavej C, de Castro Faria S, Tamm EP, Benjamin RS, Johnson MM, et al. CT evaluation of the response of gastrointestinal stromal tumors after imatinib mesylate treatment: a quantitative analysis correlated with FDG PET findings. Am J Roentgenol 2004; 183:1619-28. https://doi. org/10.2214/ajr.183.6.01831619[12] Stroobants S, Goeminne J, Seegers M, Dimitrijevic S, Dupont P, Nuyts J, et al. 18FDG-Positron emission tomography for the early prediction of response in advanced soft tissue sarcoma treated with imatinib mesylate (Glivec). Eur J Cancer 2003; 39:2012-20. https://doi.org/10.1016/S0959-8049(03)00073-X
[13] Lim J, Cho SW, Lee HS, Kim HS, Kim YH, Park BS. Extra- Gastrointestinal Stromal Tumor Presenting as an Anterior Chest Wall Mass. Korean J Thorac Cardiovasc Surg 2017; 50(4):308- 11. https://doi.org/10.5090/kjtcs.2017.50.4.308
[14] Williams A, Gutzeit A, Germer M, Pless M: PET-Negative Gastrointestinal Stromal Tumors. Case Rep Oncol 2013; 6:508-13. https://doi.org/10.1159/000355432
[15] Schaefer IM, Mariño-Enríquez A, Fletcher JA. What is New in Gastrointestinal Stromal Tumor?. Adv Anat Pathol 2017; 24(5):259-67. https://doi.org/10.1097/ PAP.0000000000000158
[16] Demetri GD, von Mehren M, Antonescu CR, DeMatteo RP, Ganjoo KN, Maki RG, et al. NCCN Task Force report: update on the management of patients with gastrointestinal stromal tumors. J Natl Compr Canc Netw 2010; 8(suppl 2):S1-S44. https://doi.org/10.6004/jnccn.2010.0116
| Files | ||
| Issue | Vol 8 No 3 (2023): May-June | |
| Section | Case Report(s) | |
| DOI | https://doi.org/10.18502/crcp.v8i3.14240 | |
| Keywords | ||
| Chest wall EGIST (extra gastrointestinal stromal tumors) Malignant Unusual tumour FDG PET/CT | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Gupta N, Verma S, Thakur P. Extra Gastrointestinal Stromal Tumour (EGIST) of Chest Wall Detected on 18 F-FDG PET/CT: A Case Report and Brief Review of Literature. CRCP. 2023;8(3):130-134.
