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伊马替尼治疗后出现软骨样分化的复发性胃肠道间质瘤:1例罕见病例及文献复习

Recurrent Gastrointestinal Stromal Tumor With Chondroid Differentiation After Imatinib Therapy: An Unusual Case and Literature Review.

作者信息

Le Patricia, Monika Fnu, Sabri Ahmed, Kovar Joyce, Dietz Nicholas

机构信息

Pathology, Creighton University School of Medicine, Omaha, USA.

出版信息

Cureus. 2024 Feb 24;16(2):e54842. doi: 10.7759/cureus.54842. eCollection 2024 Feb.

Abstract

Gastrointestinal stromal tumor (GIST) is the most common mesenchymal tumor in the gastrointestinal tract and is most commonly seen in the stomach. The standard treatment for patients with advanced GISTs include both surgical resection and imatinib therapy. There have been cases that document the alterations of patients' GIST histomorphology both with primary GIST prior to imatinib therapy and with recurrent GIST after imatinib therapy. However, there has been no documented case of a patient who has recurrent GIST with chondroid differentiation at the primary site after imatinib therapy. In this article, we report an incidental finding of a 58-year-old patient who had two treatments of imatinib therapy prior to surgical resection of her recurrent GIST in her stomach. We also explore through a mini-literature review the various cases of GIST with chondroid differentiation that have been reported to compare the histomorphology, immunophenotype, and patient demographic of these cases. This article is significant for reporting a rare finding of GIST after imatinib therapy and highlights the various presentations that GIST could acquire after imatinib therapy that exclude another malignant process, such as chondrosarcoma.

摘要

胃肠道间质瘤(GIST)是胃肠道最常见的间叶性肿瘤,最常发生于胃。晚期GIST患者的标准治疗包括手术切除和伊马替尼治疗。有病例记录了伊马替尼治疗前原发性GIST以及伊马替尼治疗后复发性GIST患者的GIST组织形态学改变。然而,尚无文献报道伊马替尼治疗后原发性部位出现软骨样分化复发性GIST的患者。在本文中,我们报告了一例偶然发现的58岁患者,该患者在手术切除胃复发性GIST之前接受了两次伊马替尼治疗。我们还通过小型文献综述探讨了已报道的各种软骨样分化GIST病例,以比较这些病例的组织形态学、免疫表型和患者人口统计学特征。本文对于报道伊马替尼治疗后罕见的GIST发现具有重要意义,并强调了伊马替尼治疗后GIST可能出现的各种表现,这些表现可排除其他恶性病变,如软骨肉瘤。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef40/10963660/0082d7b09437/cureus-0016-00000054842-i01.jpg

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