Kim Young Jae, Lee Woo Jin, Won Chong Hyun, Choi Jee Ho, Lee Mi Woo
Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ann Dermatol. 2018 Jun;30(3):345-347. doi: 10.5021/ad.2018.30.3.345. Epub 2018 Apr 23.
We report a case of a 69-year-old man with metastatic cutaneous duodenal gastrointestinal stromal tumor, which led to find multiple metastases on orbital muscle and scalp. The patient presented with a rapidly growing chest nodule with mild tenderness. He underwent surgical resection for duodenal gastrointestinal stromal tumor and had been treated with imatinib for three years. Histopathological examination of the chest nodule was consistent with gastrointestinal stromal tumor. A brain magnetic resonance imaging of follow work-up revealed multiple metastases at the left superior rectus muscle and occipital scalp. Under the diagnosis with imatinib-resistant duodenal gastrointestinal stromal tumors, a second-line therapy with sunitinib was tried. After six weeks, his skin lesion was completely improved and other metastatic cancers showed a response of stable disease. This is the first reported case of a cutaneous metastasis from duodenal GIST. This report emphasizes the importance of a full-skin examination in patients with a medical history of gastrointestinal stromal tumor which leads to find multiple metastases.
我们报告一例69岁男性转移性皮肤十二指肠胃肠道间质瘤病例，该病例导致在眼眶肌肉和头皮发现多处转移。患者出现一个快速生长且有轻度压痛的胸部结节。他接受了十二指肠胃肠道间质瘤的手术切除，并接受伊马替尼治疗三年。胸部结节的组织病理学检查结果与胃肠道间质瘤一致。后续随访的脑部磁共振成像显示左上直肌和枕部头皮有多处转移。在诊断为伊马替尼耐药的十二指肠胃肠道间质瘤后，尝试使用舒尼替尼进行二线治疗。六周后，他的皮肤病变完全改善，其他转移性癌症显示病情稳定。这是首例报道的十二指肠胃肠道间质瘤皮肤转移病例。本报告强调了对有胃肠道间质瘤病史的患者进行全面皮肤检查的重要性，这有助于发现多处转移。
