Subsequent intra-abdominal fibromatosis mimicking recurrent gastrointestinal stromal tumor

Abstract

Intra-abdominal fibromatosis (IAF) commonly develops in patients who had abdominal surgery. In rare instances, it occurs subsequent to gastrointestinal stromal tumor (GIST). This special situation has clinical significance in imatinib era. About 1000 patients with GIST in our institution from 1993 to 2010 were re-evaluated based on their clinical and pathological data, the treatment strategies and the follow-up information. We identified 2 patients who developed IAF after GIST resection. Patient 1 was a 54 year-old male and had 5 cm × 4.5 cm × 3.5 cm jejunal GIST excised on February 22, 1994. Three years later, an abdominal mass with 7 cm × 6 cm × 3 cm was identified. He was diagnosed as recurrent GIST from clinical point of view. After excision, the second tumor was confirmed to be IAF. Patient 2 was a 45-year-old male and had 6 cm × 4 cm × 3 cm duodenal GIST excised on August 19, 2008. One year later, a 4 cm mass was found at the original surgical site. The patient refused to take imatinib until the tumor increased to 8 cm six months later. The tumor continued to increase after 6 months’ imatinib therapy, decision of surgical resection was made by multidisciplinary team. The second tumor was confirmed to be IAF with size of 17 cm × 13 cm × 11 cm. Although IAF subsequent to GIST is very rare, it is of clinical significance in imatinib era as an influencing factor for making clinical decision.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1076715989961803

Subsequent Development of Desmoid Tumor after a Resected Gastrointestinal Stromal Tumor

“…It is critical to differentiate Desmoid tumors from GIST due to their different biological behavior and treatment methods. Although literature has observed an association between these two entities [ 16 , 18 , 23 ], they have different pathogenesis. Desmoid tumors can be easily mistaken for GIST as both tumors overlap in clinical presentation, morphology, and immunohistochemistry.…”

Mesenteric fibromatosis after resection for gastrointestinal stromal tumor of stomach

“…[ 15 ] Imatinib mesylate is a target-based molecule that is effective for both GIST and mesenteric fibromatosis that express c-kit . [ 7 , 16 , 17 ]…”

“…The morbidity of GIST and mesenteric fibromatosis are both rare. [ 5 , 7 , 18 , 19 ] In the majority of cases, mesenteric fibromatosis occurred after the resection of GIST. [ 14 , 20 ] Thway et al [ 21 ] reported a case of intra-abdominal desmoid tumor after resection for GIST of the sigmoid mesocolon.…”

“…Based on the immunohistochemical examination, the patient was diagnosed as a GIST, which was classified into high risk level with no doubt. [ 7 ] Subsequently, surgical excision of the lesions was done. The tumor was removed with combined resection of some portions of the omentum.…”

Intra-abdominal Desmoid Tumor after Resection for Gastrointestinal Stromal Tumor of the Small Intestine: Case Report

“…There have been only two papers that reported individuals with both GIST and desmoid tumor (19,20). The coincidence of GIST and desmoid tumor is very rare.…”