title: Subsequent intra-abdominal fibromatosis mimicking recurrent gastrointestinal stromal tumor.
abstract: Intra-abdominal fibromatosis (IAF) commonly develops in patients who had abdominal surgery. In rare instances, it occurs subsequent to gastrointestinal stromal tumor (GIST). This special situation has clinical significance in imatinib era. About 1000 patients with GIST in our institution from 1993 to 2010 were re-evaluated based on their clinical and pathological data, the treatment strategies and the follow-up information. We identified 2 patients who developed IAF after GIST resection. Patient 1 was a 54 year-old male and had 5 cm × 4.5 cm × 3.5 cm jejunal GIST excised on February 22, 1994. Three years later, an abdominal mass with 7 cm × 6 cm × 3 cm was identified. He was diagnosed as recurrent GIST from clinical point of view. After excision, the second tumor was confirmed to be IAF. Patient 2 was a 45-year-old male and had 6 cm × 4 cm × 3 cm duodenal GIST excised on August 19, 2008. One year later, a 4 cm mass was found at the original surgical site. The patient refused to take imatinib until the tumor increased to 8 cm six months later. The tumor continued to increase after 6 months' imatinib therapy, decision of surgical resection was made by multidisciplinary team. The second tumor was confirmed to be IAF with size of 17 cm × 13 cm × 11 cm. Although IAF subsequent to GIST is very rare, it is of clinical significance in imatinib era as an influencing factor for making clinical decision.
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authors.affiliation: Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, PR China.
authors.forename: Dongxian
authors.initials: D
authors.lastname: Jiang
authors.forename: Deming
authors.initials: D
authors.lastname: He
authors.forename: Yingyong
authors.initials: Y
authors.lastname: Hou
authors.forename: Weiqi
authors.initials: W
authors.lastname: Lu
authors.forename: Yuan
authors.initials: Y
authors.lastname: Shi
authors.forename: Qin
authors.initials: Q
authors.lastname: Hu
authors.forename: Shaohua
authors.initials: S
authors.lastname: Lu
authors.forename: Chen
authors.initials: C
authors.lastname: Xu
authors.forename: Yalan
authors.initials: Y
authors.lastname: Liu
authors.forename: Ju
authors.initials: J
authors.lastname: Liu
authors.forename: Yunshan
authors.initials: Y
authors.lastname: Tan
authors.forename: Xiongzeng
authors.initials: X
authors.lastname: Zhu
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001549:Benzamides / Q000627:therapeutic use; D003951:Diagnostic Errors; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D004379:Duodenal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D018221:Fibromatosis, Abdominal / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D046152:Gastrointestinal Stromal Tumors / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D000068877:Imatinib Mesylate; D007580:Jejunal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010879:Piperazines / Q000627:therapeutic use; D011237:Predictive Value of Tests; D011743:Pyrimidines / Q000627:therapeutic use; D012086:Reoperation; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D047368:Tumor Burden; D019564:Unnecessary Procedures
chemical_list: D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate
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