Multiple malignant extragastrointestinal stromal tumors of the greater omentum and results of immunohistochemistry and mutation analysis: a case report.
To report an extragastrointestinal stromal tumor (EGIST) that occurs outside the gastrointestinal tract and shows unique clinicopathologic and immunohistochemical features. In our case, we experienced multiple soft tissue tumors that originate primarily in the greater omentum, and in immunohistochemical analysis, the tumors showed features that correspond to malignant EGIST. Two large omental masses measured 15 cm multiply 10 cm and 5 cm multiply 4 cm sized and several small ovoid fragments were attached to small intestine, mesentery and peritoneum. On histologic findings, the masses were separated from small bowel serosa and had high mitotic count (115/50 HPFs). In the results of immunohistochemical stains, the tumor showed CD117 (c-kit) positive reactivity and high Ki-67 labeling index. On mutation analysis, the c-kit gene mutation was found in the juxtamembrane domain (exon 11) and it was heterozygote. Platelet-derived growth factor receptor (PDGFR) gene mutation was also found in the juxtamemembrane (exon 12) and it was polymorphism. From above findings, we proposed that there may be several mutational pathways to malignant EGIST, so further investigations could be needed to approach this unfavorable disease entity.
Department of Surgery, Korea University College of Medicine, Korea University Anam Hospital, Anam-dong 5-ga, Seoungbuk-gu, Seoul 136-705, Korea.
Jong-Han
JH
Kim
Yoon-Jung
YJ
Boo
Cheol-Woong
CW
Jung
Sung-Soo
SS
Park
Seung-Joo
SJ
Kim
Young-Jae
YJ
Mok
Sang-Dae
SD
Kim
Yang-Suk
YS
Chae
Chong-Suk
CS
Kim
D001549:Benzamides; D046152:Gastrointestinal Stromal Tumors / Q000737:chemistry / Q000235:genetics / Q000473:pathology*; D006801:Humans; D000068877:Imatinib Mesylate; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009852:Omentum; D010534:Peritoneal Neoplasms / Q000737:chemistry / Q000235:genetics / Q000473:pathology*; D010879:Piperazines / Q000627:therapeutic use; D019009:Proto-Oncogene Proteins c-kit / Q000032:analysis*; D011743:Pyrimidines / Q000627:therapeutic use; D020796:Receptor, Platelet-Derived Growth Factor alpha / Q000235:genetics*
D001549:Benzamides; D019394:Ki-67 Antigen; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D019009:Proto-Oncogene Proteins c-kit; D020796:Receptor, Platelet-Derived Growth Factor alpha