title: Malignant gastrointestinal stromal tumor of the small intestine complicated with pulmonary tuberculosis during treatment with imatinib mesylate.
abstract: We describe a patient who had a metastatic gastrointestinal stromal tumor (GIST) after previous failed extensive therapy, including multiple surgeries and hepatic artery embolization. Within a few months of starting administration of imatinib mesylate, the patient exhibited a clinical response with grade 3 neutropenia, when pulmonary tuberculosis developed. A c-kit mutation in exon 11 was detected only in metastatic liver specimens. It is unclear whether or not pulmonary tuberculosis may be induced by imatinib mesylate treatment, but caution is warranted in immunocompromised GIST patients. This is the first report of tuberculosis associated with neutropenia during imatinib mesylate treatment.
authors.affiliation: Department of Internal Medicine, Takasago Municipal Hospital, 33-1 Kamimachi, Arai-cho, Takasago 676-8585.
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Takashima
authors.forename: Naoya
authors.initials: N
authors.lastname: Igaki
authors.forename: Tomokazu
authors.initials: T
authors.lastname: Matsuda
authors.forename: Minako
authors.initials: M
authors.lastname: Ohyama
authors.forename: Suirin
authors.initials: S
authors.lastname: Kanda
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Tamada
authors.forename: Takeo
authors.initials: T
authors.lastname: Goto
mesh_terms: D000284:Administration, Oral; D000970:Antineoplastic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D000995:Antitubercular Agents / Q000627:therapeutic use; D001549:Benzamides; D003131:Combined Modality Therapy; D013505:Digestive System Surgical Procedures; D017809:Fatal Outcome; D046152:Gastrointestinal Stromal Tumors / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D000068877:Imatinib Mesylate; D007580:Jejunal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D007813:Laparotomy; D007890:Leiomyosarcoma / Q000150:complications* / Q000175:diagnosis / Q000556:secondary / Q000628:therapy; D008113:Liver Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced / Q000150:complications; D010879:Piperazines / Q000008:administration & dosage / Q000009:adverse effects*; D011743:Pyrimidines / Q000008:administration & dosage / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed; D014397:Tuberculosis, Pulmonary / Q000139:chemically induced / Q000150:complications* / Q000188:drug therapy
chemical_list: D000970:Antineoplastic Agents; D000995:Antitubercular Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate