Gastrointestinal Sistem Kanaması ile Bulgu Veren Gastrointestinal Stromal Tümörü
Özet
Gastrointestinal stromal tümörler nadir tümörlerdir. Kajal’ın interstisyel hücrelerinden kaynaklanırlar (3). Gastrointestinal trakt boyunca her alanda görülebilirler (18). Gastrointestinal traktta intralüminal, ekstralüminal veya her iki formda olabilen formları vardır. Bu olgumuzda 61 yaş kadın hasta, diyabetes mellitus ve hipotiroidisi mevcut olup, gastrointestinal sistem kanaması ile acil servise başvurması sonucu yapılan üst ve alt GİS endoskopisinde kanayan herhangi bir lezyon bulunamayıp alt ve üst batın tomografisi(BT) çekilmiştir. Tomografide sol alt kadranda kitle lezyon görülmesi sebebiyle hasta ameliyata alınmıştır. Segmenter ince bağırsak rezeksiyonu ile kitle eksize edilmiştir. Ameliyat sonrası kitlenin patoloji sonucu Gastrointesinal stromal tümör olarak gelmiştir. Hasta cerrahi iyileşme sonrasında kemoterapi için tıbbi onkolojiye yönlendirilmiştir. Takibi devam eden hastamızın olgu yönetimini literatür bilgisi eşliğinde sunmayı amaçladık.
Referanslar
Ducimetie` re F, Lurkin A, Ranche` re-Vince D, et al: Incidence of sarcoma histotypes and molecular subtypes in a prospective epidemiological study with central pathology review and molecular testing. PLoS One 6: e20294, 2011
Joensuu H, Hohenberger P, Corless CL: Gastrointestinal stromal tumour. Lancet 382:973 983,2013
Kindblom LG, Remotti HE, Aldenborg F, et al. Gastrointestinal pacemaker cell tumor (GIPACT): gastrointestinal stromal tumors show phenotypic characteristics of the interstitial cells of Cajal. Am J Pathol 1998; 152:1259-69.
Corbin KS, Kindler HL, Liauw SL. Considering the role of radiation therapy for gastrointestinal stromal tumor. Onco Targets Ther 2014; 7:713-8.
Wu PC, Langerman A, Ryan CW, et al. Surgical treatment of gastrointestinal stromal tumors in the İmatinib (STI- 571) era. Surgery 2003; 134:656-65; discussion 665-6.
Benjamin RS, Casali PG. Adjuvant İmatinib for GI Stromal Tumors: When and For How Long? J Clin Oncol 2016; 34:215-8.
DeMatteo RP. Nanoneoadjuvant therapy of gastrointestinal stromal tumor (GIST). Ann Surg Oncol 2009; 16:799-800.
Demetri GD, Reichardt P, Kang YK, et al. Efficacy and safety of regorafenib for advanced gastrointestinal stromal tumours after failure of İmatinib and sunitinib (GRID): an international, multicentre, randomised, placebo-controlled, phase 3 trial. Lancet 2013; 381:295-302.
Eisenberg BL. The SSG XVIII/AIO trial: results change the current adjuvant treatment recommendations for gastrointestinal stromal tumors. Am J Clin Oncol 2013; 36:89-90.
Gronchi A, Blay JY, Trent JC. The role of high-dose İmatinib in the management of patients with gastrointestinal stromal tumor. Cancer 2010; 116:1847-58.
Heinrich MC, von Mehren M, Demetri GD, et al. A phase 2 study of ponatinib in patients (pts) with advanced gastrointestinal stromal tumors (GIST) after failure of tyrosine kinase inhibitor (TKI) therapy: Initial report. J Clin Oncol 2014; 32:10506.
Mulet-Margalef N, Garcia-Del-Muro X. Sunitinib in the treatment of gastrointestinal stromal tumor: patient selection and perspectives. Onco Targets Ther 2016; 9:7573-82.
Emile JF, Brahimi S, Coindre JM, et al: Frequencies of KIT and PDGFRA mutations in the MolecGIST prospective population-based study differ from those of advanced GISTs. Med Oncol 29: 1765-1772, 2012
Agaimy A, Wu¨nsch PH: Lymph node metastasis in gastrointestinal stromal tumours (GIST) occurs preferentially in young patients
Zhang L, Smyrk TC, Young WF Jr, et al: Gastric stromal tumors in Carney triad are different clinically, pathologically, and behaviorally from sporadic gastric gastrointestinal stromal tumors: Findings in 104 cases. Am J Surg Pathol 34:53-64, 2010
Von Mehren M, Joensuu H. Gastrointestinal Stromal Tumors. J Clin Oncol. 2018;36(2):136-143. doi:10.1200/JCO.2017.74.9705
Joensuu H, Vehtari A, Riihim ¨ aki J, et al: Risk of recurrence of gastrointestinal stromal tumour after surgery: An analysis of pooled population-based cohorts. Lancet Oncol 13:265-274, 2012
Soreide K, Sandvik OM, Soreide JA, et al. Global epidemiology of gastrointestinal stromal tumours (GIST): A systematic review of population-based cohort studies. Cancer Epidemiol 2016; 40:39-46.
Miettinen M, Lasota J. Gastrointestinal stromal tumors: review on morphology, molecular pathology, prognosis, and differential diagnosis. Arch Pathol Lab Med 2006; 130:1466-78.
Gong J, Kang W, Zhu J, et al. CT and MR imaging of gastrointestinal stromal tumor of stomach: a pictorial review. Quant Imaging Med Surg 2012; 2:274-9.
Parab TM, DeRogatis MJ, Boaz AM, et al. Gastrointestinal stromal tumors: a comprehensive review. J Gastrointest Oncol. 2019;10(1):144-154. doi:10.21037/jgo.2018.08.20
Vernuccio F, Taibbi A, Picone D, et al. Imaging of Gastrointestinal Stromal Tumors: From Diagnosis to Evaluation of Therapeutic Response. Anticancer Res 2016; 36:2639-48.
Tateishi U, Hasegawa T, Satake M, et al. Gastrointestinal stromal tumor. Correlation of computed tomography findings with tumor grade and mortality. J Comput Assist Tomogr 2003; 27:792-8.
Lanke G, Lee JH. How best to manage gastrointestinal stromal tumor. World J Clin Oncol 2017; 8:135-44.
Chi JL, Xu M, Zhang MR, et al: Laparoscopic versus open resection for gastric gastrointestinal stromal tumors (GISTs): A size-location-matched case-control study. World J Surg 41:2345-2352, 2017
Nishida T, Goto O, Raut CP, et al: Diagnostic and treatment strategy for small gastrointestinal stromal tumors. Cancer 122:3110-3118, 2016
Wang D, Zhang Q, Blanke CD, et al: Phase II trial of neoadjuvant/adjuvant İmatinib mesylate for advanced primary and metastatic/recurrent operable gastrointestinal stromal tumors: Long-term follow-up results of Radiation Therapy Oncology Group 0132. Ann Surg Oncol 19:1074-1080, 2012
Corless CL, Ballman KV, Antonescu CR, et al: Pathologic and molecular features correlate with long-term outcome after adjuvant therapy of resected primary GI stromal tumor: The ACOSOG Z9001 trial. J Clin Oncol 32:1563-1570, 2014
Casali PG, Le Cesne A, Poveda Velasco A, et al: Time to definitive failure to the first tyrosine kinase inhibitor in localized GI stromal tumors treated with İmatinib as an adjuvant: A European Organisation for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group Intergroup randomized trial in collaboration with the Australasian Gastro-Intestinal Trials Group, UNICANCER, French Sarcoma Group, Italian Sarcoma Group, and Spanish Group for Research on Sarcomas. J Clin Oncol 33: 4276-4283, 2015
Joensuu H, Eriksson M, Sundby Hall K, et al: Adjuvant İmatinib for high-risk GI stromal tumor: Analysis of a randomized trial. J Clin Oncol 34:244-250, 2016
DeMatteo RP, Ballman KV, Antonescu CR, et al: Long-term results of adjuvant İmatinib mesylate in localized, high-risk, primary gastrointestinal stromal tumor: ACOSOG Z9000 (Alliance) intergroup phase 2 trial. Ann Surg 258:422-429, 2013
Kanda T, Nishida T, Wada N, et al: Adjuvant therapy with İmatinib mesylate after resection of primary high-risk gastrointestinal stromal tumors in Japanese patients. Int J Clin Oncol 18:38-45, 2013
Kang YK, Kang BW, Im SA, et al: Two-year adjuvant İmatinib mesylate after complete resection of localized, high-risk GIST with KIT exon 11 mutation. Cancer Chemother Pharmacol 71:43-51, 2013
Raut CP, Espat J, Maki RG, et al: Extended treatment with adjuvant İmatinib for patients with high-risk primary gastrointestinal stromal tumor (GIST): The PERCIST-5 study. J Clin Oncol 35:556s, 2017 (suppl 15S; abstr 11009)
Joensuu H, Eriksson M, Sundby Hall K, et al: One vs three years of adjuvant İmatinib for operable gastrointestinal stromal tumor: A randomized trial. JAMA 307:1265-1272, 2012
Le Cesne A, Ray-Coquard I, Bui BN, et al: Discontinuation of İmatinib in patients with advanced gastrointestinal stromal tumours after 3 years of treatment: An open-label multicentre randomised phase 3 trial. Lancet Oncol 11:942-949, 2010
Patrikidou A, Chabaud S, Ray-Coquard I, et al: Influence of İmatinib interruption and rechallenge on the residual disease in patients with advanced GIST: Results of the BFR14 prospective French Sarcoma Group randomised, phase III trial. Ann Oncol 24: 1087-1093, 2013
Raut CP, Posner M, Desai J, et al: Surgical management of advanced gastrointestinal stromal tumors after treatment with targeted systemic therapy using kinase inhibitors. J Clin Oncol 24: 2325-2331, 2006
von Mehren M, Heinrich MC, Joensuu H, et al: Follow-up results after 9 years (yrs) of the ongoing, phase II B2222 trial of İmatinib mesylate (IM) in patients (pts) with metastatic or unresectable KIT + gastrointestinal stromal tumors (GIST). J Clin Oncol 29, 2011 (suppl; abstr 10016)
Du CY, Zhou Y, Song C, et al: Is there a role of surgery in patients with recurrent or metastatic gastrointestinal stromal tumours responding to İmatinib: A prospective randomised trial in China. Eur J Cancer 50:1772-1778, 2014
Fletcher CD, Berman JJ, Corless C, et al. Diagnosis of gastrointestinal stromal tumors: a consensus approach. Int J Surg Pathol. 2002;10(2):81-89. doi:10.1177/106689690201000201
Demetri GD, von Mehren M, Antonescu CR, et al. NCCN Task Force report: update on the management of patients with gastrointestinal stromal tumors. J Natl Compr Canc Netw. 2010;8 Suppl 2(0 2):S1-S44. doi:10.6004/jnccn.2010.0116
