Aggressive gastrointestinal stromal tumor with spinal metastases: a case report.
We report a case of a 56-year-old male who presented with several month history of severe low back pain. Physical examination revealed generalized tenderness at his thoracolumbar spine without notable neuromuscular findings. Radiographs revealed a chronic compression fracture of T10 and T11 with anterior height loss. Subsequent magnetic resonance imaging demonstrated multiple lytic lesions in the thoracolumbar spine without canal compromise. During his hospital stay, he developed acute cord compression with loss of motor and sensory levels below T12 and an absence of sphincter tone. The patient was taken for emergent multilevel, posterior decompression and fusion with biopsy of the lesion. Microscopic examination of the tissue in addition to immunohistochemical analysis utilizing CD117-antibody/c-kit revealed gastrointestinal stromal tumor. Further workup revealed the primary tumor to be intra-abdominal and the patient was subsequently begun on adjuvant chemotherapy. Gastrointestinal stromal tumors should be considered in the workup of patients with bone metastasis with an unknown primary malignancy.
Department of Orthopaedic Surgery, William Beaumont Army Medical Center/Texas Tech University Health Sciences Center, 5005 North Piedras Avenue, El Paso, TX 79920.
Brian R
BR
Waterman
Department of Orthopaedic Surgery, William Beaumont Army Medical Center/Texas Tech University Health Sciences Center, 5005 North Piedras Avenue, El Paso, TX 79920.
Nicholas
N
Kusnezov
Department of Orthopaedic Surgery, William Beaumont Army Medical Center/Texas Tech University Health Sciences Center, 5005 North Piedras Avenue, El Paso, TX 79920.
John C
JC
Dunn
Department of Pathology, Texas Tech University Health Sciences Center, 4800 Alberto Avenue, El Paso, TX 79905.
M Nawar
MN
Hakim
D017809:Fatal Outcome; D005770:Gastrointestinal Neoplasms / Q000473:pathology*; D046152:Gastrointestinal Stromal Tumors / Q000175:diagnosis / Q000556:secondary*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013125:Spinal Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary*; D013904:Thoracic Vertebrae