1
|
Stetson A, Saluja S, Cameron DB, Mansfield SA, Polites SF, Honeyman JN, Dahl JP, Austin MT, Aldrink JH, Christison-Lagay ER. Surgical management of rare tumors (Part 1). Pediatr Blood Cancer 2024:e31287. [PMID: 39185712 DOI: 10.1002/pbc.31287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Revised: 08/07/2024] [Accepted: 08/10/2024] [Indexed: 08/27/2024]
Abstract
With an annual cumulative occurrence of approximately 15,000 in North America, all childhood cancers are rare. Very rare cancers as defined by both the European Cooperative Study Group for Rare Pediatric Cancers and the Children's Oncology Group fall into two principal categories: those so uncommon (fewer than 2 cases/million) that their study is challenging even through cooperative group efforts (e.g., pleuropulmonary blastoma and desmoplastic small round cell tumor) and those that are far more common in adults and therefore rarely studied in children (e.g., thyroid, melanoma, and gastrointestinal stromal tumor). Treatment strategies for these latter tumors are typically based on adult guidelines, although the pediatric variants of these tumors may harbor different genetic signatures and demonstrate different behavior. If melanoma and differentiated thyroid cancer are excluded, other rare cancer types account for only 2% of the cancers in children aged 0 to 14. This article highlights several of the most common rare tumor types.
Collapse
Affiliation(s)
- Alyssa Stetson
- Department of Surgery, Division of Pediatric Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Saurabh Saluja
- Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Danielle B Cameron
- Department of Surgery, Division of Pediatric Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sara A Mansfield
- Division of General Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA
| | | | - Joshua N Honeyman
- Division of Pediatric Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - John P Dahl
- Division of Otolaryngology, Division of Pediatric Otolaryngology, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
| | - Mary T Austin
- Department of Pediatric Surgery, University of Texas Health Science Center at Houston and Department of Surgical Oncology and Pediatrics, UT MD Anderson Cancer Center, Houston, Texas, USA
| | - Jennifer H Aldrink
- Division of General Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Emily R Christison-Lagay
- Division of Pediatric Surgery, Yale School of Medicine, Yale-New Haven Hospital, New Haven, Connecticut, USA
| |
Collapse
|
2
|
Erdeve B, Bayrak NA, Kaygusuz E, Turgutoğlu Yılmaz A, Moralıoğlu S. Gastrointestinal Stromal Tumor: A Rare Tumor of Childhood. Turk Arch Pediatr 2024; 59:422-424. [PMID: 39141077 PMCID: PMC11332528 DOI: 10.5152/turkarchpediatr.2024.24041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Accepted: 05/19/2024] [Indexed: 08/15/2024]
Affiliation(s)
- Bekir Erdeve
- Department of Pediatric Surgery, University of Health Sciences, İstanbul Zeynep Kamil Maternity and Children Diseases Health Training and Research Center, İstanbul, Türkiye
| | - Nevzat Aykut Bayrak
- Department of Pediatric Gastrenterology and Hepatology, University of Health Sciences, İstanbul Zeynep Kamil Maternity and Children Diseases Health Training and Research Center, İstanbul, Türkiye
| | - Ecmel Kaygusuz
- Department of Pathology, University of Health Sciences, İstanbul Zeynep Kamil Maternity and Children Diseases Health Training and Research Center, İstanbul, Türkiye
| | - Aslı Turgutoğlu Yılmaz
- Department of Pediatric Hematology and Oncology University of Health Sciences, Kartal Dr. Lutfi Kırdar City Hospital, İstanbul, Türkiye
| | - Serdar Moralıoğlu
- Department of Pediatric Surgery, University of Health Sciences, İstanbul Zeynep Kamil Maternity and Children Diseases Health Training and Research Center, İstanbul, Türkiye
| |
Collapse
|
3
|
Andrzejewska M, Czarny J, Skalska-Sadowska J, Jończyk-Potoczna K, Kurzawa P, Wichtowski M, Wachowiak J, Derwich K. From KIT-mutated into wild-type: dedifferentiation of gastrointestinal stromal tumor in adolescent patient-a case report. J Gastrointest Oncol 2023; 14:1887-1893. [PMID: 37720439 PMCID: PMC10502532 DOI: 10.21037/jgo-22-1111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 05/17/2023] [Indexed: 09/19/2023] Open
Abstract
Background Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract, usually found in elderly adults. It is infrequent among pediatric patients and usually differs from adult-type disease in terms of histopathology and molecular features. Case Description We describe the management of the disease in a 10-year-old female patient diagnosed with a GIST of the stomach. In total, she has undergone successively total tumor resection, unsuccessful imatinib treatment and subtotal gastric resection at relapse. The first genetic test from primary tumor confirmed KIT mutations in exons 13 and 17, while the repeated genetic screening using tumor sample from subtotal gastric resection revealed no KIT or platelet-derived growth factor receptor α (PDGFRA) genes mutations. Such dedifferentiation from adult type (thus KIT-mutated) into wild-type (without KIT or PDGFRA mutation) has not been reported so far to the best of our knowledge. Currently, the patient is observed, and no further pharmacological nor surgical treatment has been administered. Conclusions The case underlines the importance of genetic profiling combined with non-standard diagnostics (both histopathological and radiological) due to the treatment efficacy prediction. We moreover emphasize the necessity to create worldwide standards on the diagnostics and treatment of GIST in pediatric patients that would include options of targeted therapies.
Collapse
Affiliation(s)
- Marta Andrzejewska
- Faculty of Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Jakub Czarny
- Faculty of Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - Jolanta Skalska-Sadowska
- Department of Pediatric Oncology, Hematology and Transplantology, Institute of Pediatrics, Poznan University of Medical Sciences, Poznan, Poland
| | - Katarzyna Jończyk-Potoczna
- Department of Pediatric Radiology, Institute of Pediatrics, Poznan University of Medical Sciences, Poznan, Poland
| | - Paweł Kurzawa
- Department of Pathology and Clinical Immunology, Poznan University of Medical Sciences, Poznan, Poland
| | - Mateusz Wichtowski
- Clinic of Surgical Oncology, Institute of Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Wachowiak
- Department of Pediatric Oncology, Hematology and Transplantology, Institute of Pediatrics, Poznan University of Medical Sciences, Poznan, Poland
| | - Katarzyna Derwich
- Department of Pediatric Oncology, Hematology and Transplantology, Institute of Pediatrics, Poznan University of Medical Sciences, Poznan, Poland
| |
Collapse
|
4
|
Andrzejewska M, Czarny J, Derwich K. Latest Advances in the Management of Pediatric Gastrointestinal Stromal Tumors. Cancers (Basel) 2022; 14:4989. [PMID: 36291774 PMCID: PMC9599787 DOI: 10.3390/cancers14204989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 09/28/2022] [Accepted: 10/10/2022] [Indexed: 11/21/2022] Open
Abstract
Gastrointestinal stromal tumor is the most common mesenchymal neoplasm of the gastrointestinal tract, usually found in elderly adults. It is infrequent among pediatric patients and usually differs biologically from adult-type diseases presenting mutations of KIT and PDGFR genes. In this population, more frequent is the wild-type GIST possessing SDH, TRK, RAS, NF1 mutations, among others. Both tumor types require individualized treatment with kinase inhibitors that are still being tested in the pediatric population due to the different neoplasm biology. We review the latest updates to the management of pediatric gastrointestinal tumors with a particular focus on the advances in molecular biology of the disease that enables the definition of possible resistance. Emerging treatment with kinase inhibitors that could serve as targeted therapy is discussed, especially with multikinase inhibitors of higher generation, the effectiveness of which has already been confirmed in the adult population.
Collapse
Affiliation(s)
- Marta Andrzejewska
- Faculty of Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland or
| | - Jakub Czarny
- Faculty of Medicine, Poznan University of Medical Sciences, 61-701 Poznan, Poland or
| | - Katarzyna Derwich
- Department of Pediatric Oncology, Hematology and Transplantology, Institute of Pediatrics, Poznan University of Medical Sciences, 60-355 Poznan, Poland
| |
Collapse
|