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Ma J, Zhu J, Yu S, Zhou C, Duan S, Zhang Y. An ileal gastrointestinal stromal tumor misdiagnosed as pelvic metastases from rectal cancer: a case report. Front Oncol 2023; 13:1164391. [PMID: 37182150 PMCID: PMC10166831 DOI: 10.3389/fonc.2023.1164391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/05/2023] [Indexed: 05/16/2023] Open
Abstract
With the advancement of imaging and pathological diagnostic methods, it is not uncommon to see synchronous gastrointestinal stromal tumors (GIST) and other primary cancers, the most common of which are synchronous gastric cancer and gastric GIST. However, synchronous advanced rectal cancer and high-risk GIST in the terminal ileum are extremely rare, and they are easily misdiagnosed as rectal cancer with pelvic metastases due to their special location near iliac vessels. Herein, we report a 55-year-old Chinese woman with rectal cancer. Preoperative imaging revealed a middle and lower rectal lesion with a right pelvic mass (considered possible metastasis from rectal cancer). Through multidisciplinary discussions, we suspected the possibility of rectal cancer synchronous with a GIST in the terminal ileum. Intraoperative exploration by laparoscopy revealed a terminal ileal mass with pelvic adhesion, a rectal mass with plasma membrane depression, and no abdominal or liver metastases. Laparoscopic radical proctectomy (DIXON) plus partial small bowel resection plus prophylactic loop ileostomy was performed, and the pathological report confirmed the coexistence of advanced rectal cancer and a high-risk ileal GIST. The patient was treated with the chemotherapy (CAPEOX regimen) plus targeted therapy(imatinib) after surgery, and no abnormalities were observed on the follow-up examination. Synchronous rectal cancer and ileal GIST are rare and easily misdiagnosed as a rectal cancer with pelvic metastases, and careful preoperative imaging analysis and prompt laparoscopic exploration are required to determine the diagnosis and prolong patient survival.
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Affiliation(s)
- Jun Ma
- Department of General Surgery, Anqing Municipal Hospital, Anqing, China
| | - Juan Zhu
- Department of Imaging, Anqing Municipal Hospital, Anqing, China
| | - Shuihong Yu
- Research and Experimental Center, Anqing Medical and Pharmaceutical College, Anqing, China
| | - Chaoping Zhou
- Department of General Surgery, Anqing Municipal Hospital, Anqing, China
| | - Shuqiang Duan
- Department of Pathology, Anqing Municipal Hospital, Anqing, China
| | - Yaming Zhang
- Department of General Surgery, Anqing Municipal Hospital, Anqing, China
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Gastrointestinal stromal tumor with skeinoid fibers: an unusual presentation. Tech Coloproctol 2018; 22:895-897. [DOI: 10.1007/s10151-018-1893-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 11/20/2018] [Indexed: 10/27/2022]
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Feng F, Tian Y, Liu Z, Xu G, Liu S, Guo M, Lian X, Fan D, Zhang H. Clinicopathological features and prognosis of colonic gastrointestinal stromal tumors: evaluation of a pooled case series. Oncotarget 2016; 7:40735-40745. [PMID: 27166191 PMCID: PMC5130040 DOI: 10.18632/oncotarget.9196] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Accepted: 04/16/2016] [Indexed: 01/03/2023] Open
Abstract
Background Due to the extremely rare incidence, data about colonic GISTs are limited. Therefore, aim of the present study was to explore clinicopathological characteristics and prognosis of colonic GISTs. Patients and Methods Colonic GISTs cases were obtained from our center and from case report and clinical studies extracted from MEDLINE. Clinicopathological features and survivals were analyzed. Results There were 79 colonic GISTs patients with a female predominance. The median age was 66 years (range 0.17-84). The median tumor size was 5.8 cm (range 0.5-29). The most common location was sigmoid colon (45.8%), followed by transverse colon (19.5%). The majority of colonic GISTs were high risk (70.8%). Mitotic index was correlated with gender (P = 0.002) and tumor size (P = 0.005), and tumor location was correlated with age (P = 0.017). The five year DFS and DSS were 57.4% and 61.6%, respectively. Mitotic index and NIH risk classification were associated with prognosis of colonic GISTs. However, mitotic index was the only independent risk factor. The distribution of tumor size and NIH risk classification were significantly different between colonic and gastric GISTs (both P = 0.000). The DFS and DSS of colonic GISTs were significantly lower than that of gastric GISTs (P = 0.012 and P = 0.002, respectively). Conclusions The most common location for colonic GISTs was sigmoid colon. Most tumors were high risk. Mitotic index was the only independent risk factor for prognosis of colonic GISTs. Colonic GISTs differ significantly from gastric GISTs in respect to clinicopathological features. The prognosis of colonic GISTs was worse than that of gastric GISTs.
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Affiliation(s)
- Fan Feng
- Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yangzi Tian
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Zhen Liu
- Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Guanghui Xu
- Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Shushang Liu
- Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Man Guo
- Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Xiao Lian
- Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Daiming Fan
- Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Hongwei Zhang
- Department of Digestive Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
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