Primary Extra-Gastrointestinal Stromal Tumors (E-GIST) of the Liver, about Two Cases and Review of the Literature Oncology Hospital Experience at Chu Hassan II in FES
Introduction: Primary extra-gastrointestinal stromal tumors (E-GIST) of the liver are
rare. The clinical presentation can range from asymptomatic to bleeding or
manifestations of mass effect. Cancer surgery followed by adjuvant treatment
with imatinib is the standard of care. However, in special circumstances, a
cytoreductive approach may represent a therapeutic option. We describe here the
case of two patients who presented with a painful and protruding epigastric
mass, the first case was a localized E-GIST candidate for neoadjuvant treatment
with imatinib with complete resection surgery thereafter with very good
evolution, and the second is that of an E-GIST of the liver at an advanced
stage with an evolution very quick to death.Conclusion: Primary liver E-GIST is a rare condition. Treatment is based on systemic therapy and total resection surgery.
However, cytoreductive surgery will be required when complete resection is not
possible.
References
[1]
Hu, X., Forster, J. and Damjanov, I. (2003) Primary Malignant Gastrointestinal Stromal Tumor of the Liver. Archives of Pathology & Laboratory Medicine, 127, 1606-1608. https://doi.org/10.5858/2003-127-1606-PMGSTO
[2]
Feng, F., Tian, Y., Liu, Z., Xu, G., Liu, S., Guo, M., Lian, X., Fan, D. and Zhang, H. (2016) Clinicopathologic Features and Clinical Outcomes of Esophageal Gastrointestinal Stromal Tumor: Evaluation of a Pooled Case Series. Medicine, 95, e2446.
https://doi.org/10.1097/MD.0000000000002446
[3]
Vanel, D., Albiter, M., Shapeero, L., Le Cesne, A., Bonvalot, S., Le, P.C., Terrier, P., Petrow, P., Caillet, H. and Dromain, C. (2005) Role of Computed Tomography in the Follow-Up of Hepatic and Peritoneal Metastases of GIST under Imatinib Mesylate Treatment: A Prospective Study of 54 Patients. European Journal of Radiology, 54, 118-123. https://doi.org/10.1016/j.ejrad.2005.01.012
[4]
Fletcher, C.D., Berman, J.J., Corless, C., Gorstein, F., Lasota, J., Longley, B.J., Miettinen, M., O’Leary, T.J., Remotti, H., Rubin, B.P., Shmookler, B., Sobin, L.H. and Weiss, S.W. (2002) Diagnosis of Gastrointestinal Stromal Tumors: A Consensus Approach. Human Pathology, 33, 459-465.
https://doi.org/10.1053/hupa.2002.123545
[5]
De Chiara, A., De Rosa, V., Lastoria, S., Franco, R., Botti, G., Iaffaioli, V.R. and Apice, G. (2006) Primary Gastrointestinal Stromal Tumor of the Liver with Lung Metastases Successfully Treated with STI-571 (Imatinib Mesylate). Frontiers in Bioscience-Landmark, 11, 498-501. https://doi.org/10.2741/1813
[6]
Reith, J.D., Goldblum, J.R., Lyles, R.H. and Weiss, S.W. (2000) Extragastrointestinal (Soft Tissue) Stromal Tumors: An Analysis of 48 Cases with Emphasis on Histologic Predictors of Outcome. Modern Pathology, 13, 577-585.
https://doi.org/10.1038/modpathol.3880099
[7]
Miettinen, M. and Lasota, J. (2006) Gastrointestinal Stromal Tumors: Pathology and Prognosis at Different Sites. Seminars in Diagnostic Pathology, 23, 70-83.
https://doi.org/10.1053/j.semdp.2006.09.001
[8]
Sheppard, K., Kinross, K.M., Solomon, B., Pearson, R.B. and Phillips, W.A. (2012) Targeting PI3 Kinase/AKT/mTOR Signaling in Cancer. Critical Reviews in Oncogenesis, 17, 69-95. https://doi.org/10.1615/CritRevOncog.v17.i1.60
[9]
Sircar, K., Hewlett, B.R., Huizinga, J.D., Chorneyko, K., Berezin, I. and Riddell, R.H. (1999) Interstitial Cells of Cajal as Precursors of Gastrointestinal Stromal Tumors. The American Journal of Surgical Pathology, 23, 377-389.
https://doi.org/10.1097/00000478-199904000-00002
[10]
Miettinen, M., Majidi, M. and Lasota, J. (2002) Pathology and Diagnostic Criteria of Gastrointestinal Stromal Tumors (GISTs): A Review. European Journal of Cancer, 38, S39-S51. https://doi.org/10.1016/S0959-8049(02)80602-5
[11]
Bhoy, T., Lalwani, S., Mistry, J., Varma, V., Kumaran, V., Nundy, S. and Mehta, N. (2014) Primary Hepatic Gastrointestinal Stromal Tumor. Tropical Gastroenterology, 35, 252-253. https://doi.org/10.7869/tg.225
[12]
CarrilloColmenero, A.M., SerradillaMartìn, M., Redondo, O.M.D., Ramos, P.F.M. and LòpezLeiva, P. (2017) Giant Primary Extra Gastrointestinal Stromal Tumor of the Liver. Cirugía Española, 95, 547-550.
https://doi.org/10.1016/j.cireng.2017.11.002
[13]
Cheng, X., Chen, D., Chen, W. and Sheng, Q. (2016) Primary Gastrointestinal Stromal Tumor of the Liver: A Case Report and Review of the Literature. Oncology Letters, 12, 2772-2776. https://doi.org/10.3892/ol.2016.4981
[14]
Hu, H.J., Fu, Y.Y. and Li, F.Y. (2019) Primary Gastrointestinal Stromal Tumor of the Liver. Clinical Gastroenterology and Hepatology, 17, e106.
https://doi.org/10.1016/j.cgh.2018.07.035
[15]
Joyon, N., Dumortier, J., Aline-Fardin, A., Caramella, C., Valette, P.J., Blay, J.Y., Scoazec, J.Y. and Dartigues, P. (2018) Gastrointestinal Stromal Tumors (GIST) Presenting in the Liver: Diagnostic, Prognostic and Therapeutic Issues. Clinics and Research in Hepatology and Gastroenterology, 42, e23-e28.
https://doi.org/10.1016/j.clinre.2017.05.010
[16]
Kim, H.O., Kim, J.E., Bae, K.S., Choi, B.H., Jeong, C.Y. and Lee, J.S. (2014) Imaging Findings of Primary Malignant Gastrointestinal Stromal Tumor of the Liver. Japanese Journal of Radiology, 32, 365-370. https://doi.org/10.1007/s11604-014-0307-z
[17]
Lin, X.K., Zhang, Q., Yang, W.L., Shou, C.H., Liu, X.S., Sun, J.Y. and Yu, J.R. (2015) Primary Gastrointestinal Stromal Tumor of the Liver Treated with Sequential Therapy. World Journal of Gastroenterology, 21, 2573-2576.
https://doi.org/10.3748/wjg.v21.i8.2573
[18]
Liu, L., Zhu, Y., Wang, D., Yang, C., Zhang, Q.I., Li, X. and Bai, Y. (2016) Coexisting and Possible Primary Extra-Gastrointestinal Stromal Tumors of the Pancreas and Liver: A Single Case Report. Oncology Letters, 11, 3303-3307.
https://doi.org/10.3892/ol.2016.4420
[19]
Lok, H.T., Chong, C.N., Chan, A.W., Fong, K.W., Cheung, Y.S., Wong, J., Lee, K.F. and Lai, P.B. (2017) Primary Hepaticgastrointestinal Stromal Tumor Presented with Rupture. Hepatobiliary Surgery and Nutrition, 6, 65-66.
https://doi.org/10.21037/hbsn.2017.01.11
[20]
Louis, A.R., Singh, S., Gupta, S.K. and Sharma, A. (2014) Primary GIST of the Liver Masquerading as Primary Intra-Abdominal Tumour: A Rare Extra-Gastrointestinal Stromal Tumour (EGIST) of the Liver. The Journal of Gastrointestinal Oncology 45, 392-394. https://doi.org/10.1007/s12029-013-9514-6
[21]
Luo, X.L., Liu, D., Yang, J.J., Zheng, M.W., Zhang, J. and Zhou, X.D. (2009) Primary Gastrointestinal Stromal Tumor Ofthe Liver: A Case Report. World Journal of Gastroenterology, 15, 3704-3707. https://doi.org/10.3748/wjg.15.3704
[22]
Mao, L., Chen, J., Liu, Z., Liu, C.J., Tang, M. and Qiu, Y.D. (2015) Extracorporeal Hepatic Resection and Autotransplantation for Primary Gastrointestinal Stromal Tumor of the Liver. Transplantation Proceedings, 47,174-178.
https://doi.org/10.1016/j.transproceed.2014.09.111
[23]
Ochiai, T., Sonoyama, T., Kikuchi, S., Ikoma, H., Kubota, T., Nakanishi, M., Ichikawa, D., Fujiwara, H., Okamoto, K., Sakakura, C., Kokuba, Y., Taniguchi, H. and Otsuji, E. (2009) Primary Large Gastrointestinal Stromal Tumor of the Liver: Report of a Case. Surgery Today, 39, 633-636. https://doi.org/10.1007/s00595-008-3885-5
[24]
Su, Y.Y., Chiang, N.J., Wu, C.C. and Chen, L.T. (2015) Primary Gastrointestinal Stromal Tumor of the Liver in an Anorectal Melanoma Survivor: A Case Report. Oncology Letters, 10, 2366-2370. https://doi.org/10.3892/ol.2015.3561
[25]
Yamamoto, H., Miyamoto, Y., Nishihara, Y., Kojima, A., Imamura, M., Kishikawa, K., Takase, Y., Ario, K., Oda, Y. and Tsuneyoshi, M. (2010) Primary Gastrointestinal Stromal Tumor of the Liver with PDGFRA Gene Mutation. Human Pathology, 41, 605-609.
[26]
Zhao, X. and Yue, C. (2012) Gastrointestinal Stromal Tumor. Journal of Gastrointestinal Oncology, 3, 189-208.
[27]
Zhou, B., Zhang, M., Yan, S. and Zheng, S. (2014) Primary Gastrointestinal Stromal Tumor of the Liver: Report of a Case. Surgery Today, 44, 1142-1146.
https://doi.org/10.1007/s00595-013-0521-9
[28]
Nagai, T., Ueda, K., Hakoda, H., Okata, S., Nakata, S., Taira, T., Aoki, S., Mishima, H., Sako, A., Maruyama, T. and Okumura, M. (2016) Primary Gastrointestinal Stromal Tumor of the Liver: A Case Report and Review of the Literature. Surgical Case Reports, 2, Article No. 87. https://doi.org/10.1186/s40792-016-0218-6
[29]
Wang, Y., Liu, Y., Zhong, Y. and Ji, B. (2016) Malignant Extra-Gastrointestinal Stromal Tumor of the Liver: A Case Report. Oncology Letters, 11, 3929-3932.
https://doi.org/10.3892/ol.2016.4531
[30]
Yu, M.H., Lee, J.M., Baek, J.H., Han, J.K. and Choi, B.I. (2014) MRI Features of Gastrointestinal Stromal Tumors. American Journal of Roentgenology, 203, 980-991.
https://doi.org/10.2214/AJR.13.11667
[31]
Ghanem, N., Altehoefer, C., Furtwaängler, A., Winterer, J., Schaäfer, O., Springer, O., Kotter, E. and Langer, M. (2003) Computed Tomography in Gastrointestinal Stromal Tumors. European Radiology, 13, 1669-1678.
https://doi.org/10.1007/s00330-002-1803-6
[32]
Ejaz, A., Reames, B.N., Maithel, S., Poultsides, G.A., Bauer, T.W., Fields, R.C., Weiss, M.J., Marques, H.P., Aldrighetti, L. and Pawlik, T.M. (2018) Cytoreductive Debulking Surgery among Patients with Neuroendocrine Liver Metastasis: A Multi-Institutional Analysis. HPB, 20, 277-284.
https://doi.org/10.1016/j.hpb.2017.08.039
[33]
Griffiths, C.T. (1975) Surgical Resection of Tumor Bulk in the Primary Treatment of Ovarian Carcinoma. Journal of the National Cancer Institute Monographs, 42, 101-104.
[34]
Qiu, H.B., Zhou, Z.G., Feng, X.Y., Liu, X.C., Guo, J., Ma, M.Z., Chen, Y.B., Sun, X.W. and Zhou, Z.W. (2018) Advanced Gastrointestinal Stromal Tumor Patients Benefit from Palliative Surgery after Tyrosine Kinase Inhibitors Therapy. Medicine, 97, e9097. https://doi.org/10.1097/MD.0000000000009097
[35]
Tamura, J., Nakayama, Y., Kitaguchi, K., Ura, K., Taira, K., Ooe, H., Yoshikawa, A., Ishigami, S. and Baba, N. (2009) A Successfully Resected Case of Liver Metastasis of Gastrointestinal Stromal Tumor Responding to Neoadjuvant Chemotherapy with Imatinib Mesylate and Interventional Radiology. Japanese Journal of Cancer and Chemotherapy, 36, 1769-1772
[36]
Demetri, G.D., von Mehren, M., Blanke, C.D., Van den Abbeele, A.D., Eisenberg, B., Roberts, P.J., Heinrich, M.C., Tuveson, D.A., Singer, S., Janicek, M., Fletcher, J.A., Silverman, S.G., Silberman, S.L., Capdeville, R., Kiese, B., Peng, B., Dimitrijevic, S., Druker, B.J., Corless, C., Fletcher, C.D. and Joensuu, H. (2002) Efficacy and Safety of Imatinib Mesylate in Advanced Gastrointestinal Stromal Tumors. The New England Journal of Medicine, 347, 472-480.
https://doi.org/10.1056/NEJMoa020461
[37]
Li, Z.Y., Liang, Q.L., Chen, G.Q., Zhou, Y. and Liu, Q.L. (2012) Extra-Gastrointestinal Stromal Tumor of the Liver Diagnosed by Ultrasound-Guided Fine Needle Aspiration Cytology: A Case Report and Review of the Literature. Archives of Medical Science, 8, 392-397. https://doi.org/10.5114/aoms.2012.28572
