#PAGE_PARAMS# #ADS_HEAD_SCRIPTS# #MICRODATA#

Ovarian Tumor as a Complication in Diagnosis of the Extraintestinal Gastrointestinal Stromal Tumor – Two Case Reports


Authors: Z. Kinkor 1;  O. Daum 2
Authors‘ workplace: Bioptická laboratoř s. r. o., vedoucí prof. MUDr. A. Skálová, CSc. 1;  Šiklův ústav patologie, LF UK, Plzeň, přednosta, prof. MUDr. M. Michal, Ph. D. 2
Published in: Ceska Gynekol 2008; 73(1): 54-57

Overview

Objective:
The aim of this study is to address difficulties in diagnosis of the extraintestinal gastrointestinal stromal tumor (GIST) when even in ovary is the tumor. One should ever think of the GIST in the case of peritoneal dissemination of the spindle/epithelioid cell tumor. In contrary, the late intraabdominal recurrence of primary both epithelial and non-epithelial tumor of genital tract can be undistinguishable by pure morphology. Complete clinical records and accurate operation field topography are both of great value. Documenting this phenomenon, presented is both late intraabdominal dissemination of primary uterine endometrial stromal sarcoma and massive ovarian involvement by extraintestinal GIST.

Design:
Two case reports.

Setting:
Biopsy Lab s.r.o. and Šikl’s Department of Pathology, Charles University and Faculty Hospital, Pilsen.

Methods:
The two casuistic reports are covered in detail including broad immunohistochemistry (LSAB+, Dako) and genetics (ABI Prism 310, PE/Applied Biosystems).

Results:
In 75-year-old woman, 5 cm tumor in maximum diameter of the mesentery was diagnosed as an extraintestinal GIST. Multiple peritoneal recurrence occurred ten years later and the tumor has been reclassified as a disseminated endometroid stromal sarcoma. Ultimately, comprehensive search of clinical files confirmed hysterectomy and adnexotomy in 1973. The second case describes 49-year-old woman operated for tumorous obliteration of the small pelvis where a tumor 9 cm in maximum diameter was found. Initially, predominant epitheloid morphology of the tumor led to the diagnosis of primary epithelial malignancy, sex-cord stromal tumor or metastatic melanoma of the ovary. Finally, the help of immunohistochemistry and molecular biology rendered the tumor as an extraintestinal GIST, ovarian primary not excluded.

Key words:
gastrointestinal stromal tumor, extraintestinal GIST, ovary, endometroid stromal sarcoma, peritoneal dissemination


Sources

1. Abraham, SC. Distinguishing GIST from their mimics: an update. Ad Anat Pathol, 2007, 14, p. 178-188.

2. Fletcher, CDM., Bermann, JJ., Corless, CL. Diagnosis of gastrointestinal stromal tumor. A concensus approach. Hum Pathol, 2002, 33, p. 459-465.

3. Haller, F., Schulten, HJ., Armbrust, T., et al. Multicentric sporadic gastrointestinal stromal tumors (GIST) of the stomach with distinct clonal origin: differential diagnosis to familial and syndromal GIST variants and peritoneal metastasis. Am J Surg Pathol, 2007, 31, p. 933-937.

4. Hirota, S., Isozaki, K. Pathology of GIST. Pathol Int, 2006, 56, p. 1-9.

5. Hornick, JL., Fletcher, CDM. The role of Kit in the management of patients with GISTs. Hum Pathol, 2007, 38, p. 679-687.

6. Hu, X., Forster, J., Damjanov, I. Primary malignant gastrointestinal tumor of the liver. Arch Pathol Lab Med, 2003, 127, p. 1606-1608.

7. Irwing, JA., Lerwill, MF., Young, RH., et al. Gastrointestinal stromal tumors metastatic to the ovary. A report of five cases. Am J Surg Pathol, 2005, 29, p. 920-926.

8. Lam, MM., Corless CL., Goldblum, JR., et al. Extragastrointestinal stromal tumors presenting as vulvovaginal/rectovaginal septal masses: a diagnostic pitfall. Int J Gyn Pathol, 2006, 25, p. 288-292.

9. Lee, CH., Lyn, YH., Lyn, HY. GIST of the prostate: a case report and literature review. Hum Pathol, 2006, 37, p. 1361-1365.

10. Rubin, BP. GIST: an update. Histopathol., 2006, 48, p. 83-96.

11. Tornillo, L., Terracciano, ML. An update molecular genetics of GIST. J Clin Pathol, 2006, 59, p. 557-563.

Labels
Paediatric gynaecology Gynaecology and obstetrics Reproduction medicine
Login
Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account

#ADS_BOTTOM_SCRIPTS#