Maria Ola M, Alghamdi Ossama, Baabdullah Razan, El-Hakim Michel, Al-Halabi Hani, Makhoul Nicholas M
Faculty of Dentistry, McGill University, Montreal, Quebec, Canada.
Maxillofacial Surgery Department, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 Jan;133(1):e1-e5. doi: 10.1016/j.oooo.2021.06.017. Epub 2021 Jul 3.
Gastrointestinal stromal tumors (GISTs) form commonly in the stomach, small intestine, colorectum, and esophagus. Metastatic GIST occurs in up to 50% of patients at presentation. The liver and peritoneal cavity are the most common (93%) metastatic sites; head and neck metastases are extremely rare. This report describes a unique case of a 77-year-old man who was diagnosed with a duodenal GIST that had been completely resected 15 years ago. Eleven years after complete resection, he presented with liver metastases and then received multiple lines of systemic therapy and ablative radiotherapy. In 2015, he presented to our oral and maxillofacial surgery department with a left exophytic maxillary mass that filled the left maxillary sinus. Incisional biopsy confirmed metastatic GIST. Further evaluation revealed extensive metastases in the patient's liver, lungs, spleen, abdominal wall, and lymph nodes. After adequate staging, the patient's condition was deemed palliative, and he was referred to the radiation oncology department for palliative treatment of the symptomatic maxillary lesion. To our knowledge, this is the first reported case of maxillary metastasis from a duodenal GIST. Inclusion of GIST in the differential diagnosis of jaw tumors in patients with nonoral malignancies is recommended. The literature on oral metastasis of GIST is reviewed and discussed in this case report.
胃肠道间质瘤（GISTs）通常发生于胃、小肠、结肠直肠和食管。转移性GIST在初诊时见于高达50%的患者。肝脏和腹腔是最常见的转移部位（93%）；头颈部转移极为罕见。本报告描述了一例独特病例，一名77岁男性15年前被诊断为十二指肠GIST并已完全切除。完全切除11年后，他出现肝转移，随后接受了多线全身治疗和消融放疗。2015年，他因左侧上颌肿物外生性生长并充满左侧上颌窦而就诊于我们的口腔颌面外科。切开活检确诊为转移性GIST。进一步评估发现患者肝脏、肺、脾、腹壁和淋巴结广泛转移。在进行充分的分期后，患者的病情被判定为姑息性，他被转至放射肿瘤科对有症状的上颌病变进行姑息治疗。据我们所知，这是首例十二指肠GIST上颌转移的报告病例。建议在非口腔恶性肿瘤患者颌骨肿瘤的鉴别诊断中纳入GIST。本病例报告对GIST口腔转移的文献进行了回顾和讨论。
