Marković Marina, Jurišić Vladimir, Petrović Marina, Dagović Aleksandar, Stanković Vesna, Mitrović Slobodanka
Department of Pathophysiology, Faculty of Medical Sciences, University of Kragujevac, Serbia;
Rom J Morphol Embryol. 2018;59(2):613-617.
Gastrointestinal stromal tumor (GIST) is a mesenchymal tumor of the gastrointestinal tract. Very few cases of coexistence of GIST and adenocarcinoma in other organs have been described.
We present the case of a 63-year-old female patient diagnosed with breast cancer. After five years of the diagnosis, the findings of colon adenocarcinoma and GIST in stage IA were discovered incidentally during surgical treatment of the colon carcinoma. This tumor display: mixed spindle-epithelioid cell cytological type, of moderate cellularity, mitotic index (1∕10) with low anaplasia, low proliferative status (Ki-67 index 12%), without necrosis and immunophenotype profile: antiendomysial antibody (EMA)-, vimentin+++, CD117++, CD34+++, alpha-smooth muscle actin (α-SMA)+, desmin+∕-, S-100-, CD68-.
The present case is extremely rare since the patient has adenocarcinoma with GIST in a previously diagnosed breast carcinoma. Based on this, in clinical practice should always think about possibility occurrence of synchronous and metachronous tumors.
胃肠道间质瘤（GIST）是一种胃肠道间叶肿瘤。很少有关于GIST与其他器官腺癌共存的病例报道。
我们报告一例63岁女性患者，诊断为乳腺癌。在诊断五年后，在结肠癌手术治疗期间偶然发现了IA期结肠腺癌和GIST。该肿瘤表现为：混合性梭形-上皮样细胞细胞学类型，细胞密度中等，有丝分裂指数（1/10），间变程度低，增殖状态低（Ki-67指数12%），无坏死，免疫表型特征为：抗肌内膜抗体（EMA）阴性，波形蛋白强阳性，CD117强阳性，CD34强阳性，α-平滑肌肌动蛋白（α-SMA）阳性，结蛋白弱阳性/阴性，S-100阴性，CD68阴性。
本病例极为罕见，因为患者在先前诊断的乳腺癌中同时存在腺癌和GIST。基于此，在临床实践中应始终考虑同步和异时性肿瘤发生的可能性。
