T-cell lymphoproliferative disorder potentially induced by imatinib in a patient with GIST.
BACKGROUND
A 71-year-old male patient was diagnosed as having a KIT-positive gastrointestinal stromal tumor located at the gastric antrum. With no signs of distant metastasis, the patient primarily underwent gastric surgery with antrectomy and Billroth-I-reconstruction. Owing to tumor size and mitotic index, the patient was considered at high risk of tumor relapse and thus was entered into a clinical trial to receive adjuvant imatinib treatment. 4 months after initiation of imatinib treatment, the patient presented with several newly discovered subcutaneous and intra-abdominal tumor lesions. Imatinib treatment had been tolerated well until then.


METHODS
Physical examination, blood tests, biopsies of the subcutaneous tumor lesions, tumor morphology and immunohistochemistry, PCR for the T-cell receptor gamma genes, sequential CT and PET-CT.


METHODS
Monoclonal T-cell lymphoproliferative disorder, potentially induced by imatinib.


RESULTS
Imatinib was stopped, after which the tumor lesions spontaneously regressed and, eventually, complete remission was achieved.
Verbeek
Mareike
M
III Medical Department, Klinikum rechts der Isar, Technical University Munich, Ismaningerstrasse 22, 81675 München, Germany.
Fend
Falko
F
Licht
Thomas
T
Büschenfelde
Christian Meyer zum
CM
Stollfuss
Jens
J
Peschel
Christian
C
Duyster
Justus
J
D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001549:Benzamides; D017024:Chemotherapy, Adjuvant; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D000068877:Imatinib Mesylate; D008297:Male; D010879:Piperazines / Q000009:adverse effects*; D011743:Pyrimidines / Q000009:adverse effects*; D013601:T-Lymphocytes / Q000187:drug effects*; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate