'Time is a GIFT in GIST'--the medical and paramedical perspective of a case with metastatic gastrointestinal stromal tumor.
Few recent developments in oncology have generated comparable interest as have the dramatic successes in the therapy of gastrointestinal stromal tumors (GIST) with imatinib mesylate. Imatinib, a selective tyrosine kinase inhibitor, is currently the standard of care first-line treatment for unresectable or metastatic GIST, improving survival time and delaying disease progression. The authors report a 50-year-old male patient referred as relapsed chemotherapy-resistant CD117- leiomyosarcoma. After learning about the failure of chemotherapy, the patient became depressive and considered committing a suicide. We performed a second CD117 staining. As the second analysis was found to be positive, the diagnosis of leiomyosarcoma was changed to GIST. Imatinib 600 mg/day was started. The result with imatinib was appraised as a partial response/stable disease after the chemotherapy failure. The patient's depressive mood was also improved after imatinib. The medical and paramedical perspectives of the case are presented to emphasize the importance of immunohistochemical staining and its inhibition by a novel tyrosine kinase inhibitor in GIST. All nonepithelial tumors, particularly nonepithelial abdominal tumors of leiomyoblastic appearance should be considered to be GIST unless an experienced pathologist who does CD117 staining routinely confirms a different diagnosis. Interestingly, depression due to chemotherapy failure was also alleviated with imatinib. According to a recent study, median time to progression was 24 months, and overall survival was 57 months, reaching 5 years with imatinib.


CONCLUSIONS
time is a GIFT in GIST.
Sevinc
Alper
A
Gaziantep University, School of Medicine, Department of Medical Oncology, Gaziantep Oncology Hospital, Gaziantep, Turkey. sevinc@gantep.edu.tr
Camci
Celalettin
C
D000970:Antineoplastic Agents / Q000008:administration & dosage*; D001549:Benzamides; D003131:Combined Modality Therapy; D019008:Drug Resistance, Neoplasm; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D000068877:Imatinib Mesylate; D007890:Leiomyosarcoma / Q000150:complications / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009379:Neoplasms, Muscle Tissue / Q000150:complications / Q000601:surgery; D010879:Piperazines / Q000008:administration & dosage*; D019009:Proto-Oncogene Proteins c-kit / Q000032:analysis; D011743:Pyrimidines / Q000008:administration & dosage*; D014057:Tomography, X-Ray Computed
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate; D019009:Proto-Oncogene Proteins c-kit