Lookian Pashayar P, Weisbrod Luke J, Rasmussen Jordan M, Ehlers Landon D, Chen Jie, Teichmeier Tyler R, Katzir Miki
Department of Neurosurgery, University of Nebraska Medical Center, Omaha, NE, USA.
School of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
Case Rep Oncol. 2025 May 14;18(1):675-681. doi: 10.1159/000543568. eCollection 2025 Jan-Dec.
Gastrointestinal stromal tumors (GISTs) arise from the interstitial cells of Cajal and are the most common form of gastrointestinal (GI) mesenchymal tumors. Bony metastasis is rare, with the spine being the most common location of osseous metastasis.
A 56-year-old female with presentation of acute on chronic mechanical low back pain was found to have multiple lytic lesions throughout the thoracolumbar spine arising from GIST metastases. Magnetic resonance imaging of the thoracic spine revealed a dorsal epidural enhancing mass spanning the T6-T8 levels with associated spinal cord compression and spinal cord signal change. The patient underwent urgent surgical decompression and resection of epidural tumor through T5-T8 decompressive laminectomy. Postoperatively, the patient initially did well with improvement in bilateral lower extremity sensation and bladder function. The patient passed away while at home due to undetermined causes 6 weeks postoperatively.
Here we present the case of a patient with metastatic GIST to the thoracic spine presenting with acute spinal cord compression treated with surgical resection, in addition to reviewing the literature of previous patients with metastatic GIST to the spine. We recommend that patients undergo surgical resection with adjuvant tyrosine kinase inhibitor therapy.
胃肠道间质瘤（GIST）起源于 Cajal 间质细胞，是胃肠道（GI）间充质肿瘤最常见的形式。骨转移罕见，脊柱是骨转移最常见的部位。
一名 56 岁女性，表现为慢性机械性腰痛急性发作，经检查发现胸腰椎多处溶骨性病变，由 GIST 转移所致。胸椎磁共振成像显示 T6 - T8 水平有一个硬膜外强化肿块，伴有脊髓受压和脊髓信号改变。患者接受了紧急手术减压，并通过 T5 - T8 减压性椎板切除术切除硬膜外肿瘤。术后，患者最初恢复良好，双侧下肢感觉和膀胱功能有所改善。患者术后 6 周在家中因不明原因去世。
在此，我们报告一例转移性 GIST 至胸椎并伴有急性脊髓压迫的患者，经手术切除治疗，同时回顾了既往转移性 GIST 至脊柱患者的文献。我们建议患者接受手术切除并辅助酪氨酸激酶抑制剂治疗。
