Gastrointestinal stromal tumor of the stomach with axillary lymph node metastasis: A case report.
Gastrointestinal stromal tumors (GISTs) are the most common type of gastrointestinal mesenchymal tumors, although metastasis to the perigastric lymph nodes is relatively rare, compared with liver or peritoneal metastasis. In this report, we describe a case of stomach GIST with a solitary simultaneous metastasis in the left axillary lymph node. A 68-year-old man was diagnosed with a large upper-stomach GIST, and computed tomography and positron emission tomography revealed masses in the left axilla and right mediastinum. We did not detect evidence of metastases to the liver, or other sites including the perigastric lymph nodes, although findings from the surgically resected axillary lymph nodes were compatible with GIST metastasis. Treatment using imatinib markedly reduced the gastric and mediastinal lesions, and this response persisted for 3 years. The patient subsequently experienced rapid growth of the gastric lesion without mediastinal or axilla recurrence, which required palliative surgery. Despite continuing medical treatment (sunitinib and regorafenib), the patient died of liver metastases 23 mo after the surgery. Based on our findings, it appears that the axillary lymph nodes can be a potential metastatic site for GIST metastasis.
Naoki Kubo, Nobumichi Takeuchi, Department of Surgery, Ina central Hospital, Inashi, Nagano 396-8555, Japan.
Naoki
N
Kubo
Naoki Kubo, Nobumichi Takeuchi, Department of Surgery, Ina central Hospital, Inashi, Nagano 396-8555, Japan.
Nobumichi
N
Takeuchi
D000368:Aged; D001365:Axilla; D017809:Fatal Outcome; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology*; D006801:Humans; D000068877:Imatinib Mesylate / Q000627:therapeutic use; D007211:Indoles / Q000627:therapeutic use; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D009362:Neoplasm Metastasis; D010671:Phenylurea Compounds / Q000627:therapeutic use; D049268:Positron-Emission Tomography; D011725:Pyridines / Q000627:therapeutic use; D011758:Pyrroles / Q000627:therapeutic use; D013274:Stomach Neoplasms / Q000473:pathology*; D000077210:Sunitinib; D014057:Tomography, X-Ray Computed
D007211:Indoles; D010671:Phenylurea Compounds; D011725:Pyridines; D011758:Pyrroles; C559147:regorafenib; D000068877:Imatinib Mesylate; D000077210:Sunitinib
Axillary; Gastrointestinal stromal tumor; Imatinib; Lymph node; Metastasis