What is it about?
A middle aged woman was referred with a huge liver mass. She had no history of liver disease. Pertinent laboratory test results were unremarkable. She had a history of small intestinal resection for a gastrointestinal stromal tumor (GIST) 11 years prior. A tumor biopsy revealed small round/spindle-shaped cells surrounded by fibrous tissue. Immunohistochemical stainings revealed vimentin reactivity, as well as CD117 reactivity. On c-kit sequencing, a deletion in exon 11 was identified. Based on the patient’s history, positive staining for CD117, and c-kit mutation results, the neoplasm was diagnosed as a metastatic GIST in the liver.
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Why is it important?
Although hepatic metastasis of a GIST is not uncommon, delayed metastasis over 5 years later is extremely rare.
Perspectives
A few cases of inoperable liver metastatic GISTs have been reported, most were treated by a multidisciplinary approach including imatinib administration and subsequent portal vein embolization leading to tumor shrinkage which enables curative resection.
Professor Kyung Jin Seo
The Catholic University of Korea
Read the Original
This page is a summary of: A huge necrotic liver mass in a 45-year-old woman: delayed hepatic metastasis of a gastrointestinal stromal tumor, The Korean Journal of Internal Medicine, March 2017, Korean Association of Internal Medicine (KAMJE),
DOI: 10.3904/kjim.2015.397.
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