title: Gastrointestinal stromal tumor solitary distant recurrence in the left brachialis muscle.
abstract: Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors of the gastrointestinal tract that are most commonly found in the stomach. Although GISTs can spread to the liver and peritoneum, metastasis to the skeletal muscle is very rare and only four cases have previously been reported. These cases involved concurrent skeletal metastases of primary GISTs or liver metastases. Here, we report the first case of a distant recurrence in the brachialis muscle after complete remission of an extra-luminal gastric GIST following a wedge resection of the stomach, omental excision, and adjuvant imatinib therapy for one year. Ten months after therapy completion, the patient presented with swelling and tenderness in the left arm. Magnetic resonance imaging revealed a large mass in the brachialis muscle, which showed positivity for c-kit and CD34 upon pathologic examination. This is the first reported case of a solitary distant recurrence of a GIST in the muscle after complete remission had been achieved.
authors.affiliation: Su-Sin Jin, Hyeong-Seok Jeong, Hyun-Jin Noh, Woo-Hyung Choi, Seung-Hwa Choi, Kang-Yeon Won, Dong-Pil Kim, Ji-Chan Park, Seung-Woo Lee, Division of Gastroenterology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon 301-723, South Korea.
authors.forename: Su-Sin
authors.initials: SS
authors.lastname: Jin
authors.affiliation: Su-Sin Jin, Hyeong-Seok Jeong, Hyun-Jin Noh, Woo-Hyung Choi, Seung-Hwa Choi, Kang-Yeon Won, Dong-Pil Kim, Ji-Chan Park, Seung-Woo Lee, Division of Gastroenterology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon 301-723, South Korea.
authors.forename: Hyeong-Seok
authors.initials: HS
authors.lastname: Jeong
authors.affiliation: Su-Sin Jin, Hyeong-Seok Jeong, Hyun-Jin Noh, Woo-Hyung Choi, Seung-Hwa Choi, Kang-Yeon Won, Dong-Pil Kim, Ji-Chan Park, Seung-Woo Lee, Division of Gastroenterology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon 301-723, South Korea.
authors.forename: Hyun-Jin
authors.initials: HJ
authors.lastname: Noh
authors.affiliation: Su-Sin Jin, Hyeong-Seok Jeong, Hyun-Jin Noh, Woo-Hyung Choi, Seung-Hwa Choi, Kang-Yeon Won, Dong-Pil Kim, Ji-Chan Park, Seung-Woo Lee, Division of Gastroenterology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon 301-723, South Korea.
authors.forename: Woo-Hyung
authors.initials: WH
authors.lastname: Choi
authors.affiliation: Su-Sin Jin, Hyeong-Seok Jeong, Hyun-Jin Noh, Woo-Hyung Choi, Seung-Hwa Choi, Kang-Yeon Won, Dong-Pil Kim, Ji-Chan Park, Seung-Woo Lee, Division of Gastroenterology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon 301-723, South Korea.
authors.forename: Seung-Hwa
authors.initials: SH
authors.lastname: Choi
authors.affiliation: Su-Sin Jin, Hyeong-Seok Jeong, Hyun-Jin Noh, Woo-Hyung Choi, Seung-Hwa Choi, Kang-Yeon Won, Dong-Pil Kim, Ji-Chan Park, Seung-Woo Lee, Division of Gastroenterology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon 301-723, South Korea.
authors.forename: Kang-Yeon
authors.initials: KY
authors.lastname: Won
authors.affiliation: Su-Sin Jin, Hyeong-Seok Jeong, Hyun-Jin Noh, Woo-Hyung Choi, Seung-Hwa Choi, Kang-Yeon Won, Dong-Pil Kim, Ji-Chan Park, Seung-Woo Lee, Division of Gastroenterology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon 301-723, South Korea.
authors.forename: Dong-Pil
authors.initials: DP
authors.lastname: Kim
authors.affiliation: Su-Sin Jin, Hyeong-Seok Jeong, Hyun-Jin Noh, Woo-Hyung Choi, Seung-Hwa Choi, Kang-Yeon Won, Dong-Pil Kim, Ji-Chan Park, Seung-Woo Lee, Division of Gastroenterology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon 301-723, South Korea.
authors.forename: Ji-Chan
authors.initials: JC
authors.lastname: Park
authors.affiliation: Su-Sin Jin, Hyeong-Seok Jeong, Hyun-Jin Noh, Woo-Hyung Choi, Seung-Hwa Choi, Kang-Yeon Won, Dong-Pil Kim, Ji-Chan Park, Seung-Woo Lee, Division of Gastroenterology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon 301-723, South Korea.
authors.forename: Mi-Kyong
authors.initials: MK
authors.lastname: Joung
authors.affiliation: Su-Sin Jin, Hyeong-Seok Jeong, Hyun-Jin Noh, Woo-Hyung Choi, Seung-Hwa Choi, Kang-Yeon Won, Dong-Pil Kim, Ji-Chan Park, Seung-Woo Lee, Division of Gastroenterology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon 301-723, South Korea.
authors.forename: Jeong-Goo
authors.initials: JG
authors.lastname: Kim
authors.affiliation: Su-Sin Jin, Hyeong-Seok Jeong, Hyun-Jin Noh, Woo-Hyung Choi, Seung-Hwa Choi, Kang-Yeon Won, Dong-Pil Kim, Ji-Chan Park, Seung-Woo Lee, Division of Gastroenterology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon 301-723, South Korea.
authors.forename: Hae-Joung
authors.initials: HJ
authors.lastname: Sul
authors.affiliation: Su-Sin Jin, Hyeong-Seok Jeong, Hyun-Jin Noh, Woo-Hyung Choi, Seung-Hwa Choi, Kang-Yeon Won, Dong-Pil Kim, Ji-Chan Park, Seung-Woo Lee, Division of Gastroenterology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Daejeon 301-723, South Korea.
authors.forename: Seung-Woo
authors.initials: SW
authors.lastname: Lee
mesh_terms: D000369:Aged, 80 and over; D018952:Antigens, CD34 / Q000032:analysis; D014408:Biomarkers, Tumor / Q000032:analysis; D001706:Biopsy; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000737:chemistry / Q000556:secondary* / Q000601:surgery; D006801:Humans; D007150:Immunohistochemistry; D008279:Magnetic Resonance Imaging; D019042:Muscle Neoplasms / Q000737:chemistry / Q000188:drug therapy / Q000556:secondary*; D018482:Muscle, Skeletal / Q000737:chemistry / Q000473:pathology*; D049268:Positron-Emission Tomography; D019009:Proto-Oncogene Proteins c-kit / Q000032:analysis; D013274:Stomach Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D047368:Tumor Burden; D034941:Upper Extremity
chemical_list: D018952:Antigens, CD34; D014408:Biomarkers, Tumor; D019009:Proto-Oncogene Proteins c-kit
keywords: Brachialis muscle; Distant recurrence; Gastrointestinal stromal tumor; Skeletal metastasis; Tyrosine kinase inhibitor