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Metastatic Liver Tumors in Surgical Pathology: Impact of Contemporary Diagnostic and Therapeutic Paradigms in a Tertiary Care Center.

Int J Surg Pathol 2021 Jun 14:10668969211022708. Epub 2021 Jun 14.

12250Indiana University School of Medicine, Indianapolis, IN, USA.

We analyzed metastatic liver tumors received in the department of pathology in a tertiary care center over a 3-year period. There were 509 metastatic liver tumors; counterintuitively, there were as many resections (235 cases) as biopsies (274 cases). This unexpected finding reflects contemporaneous organ-specific paradigms for diagnosis and management of metastatic liver disease in oncologic practice, and the association of our practice with a National Cancer Institute-designated comprehensive cancer center with expertise and specialization in liver surgery. Read More

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Mutations of the and gene in gastrointestinal stromal tumors among hakka population of Southern China.

Niger J Clin Pract 2021 Jun;24(6):814-820

Center for Precision Medicine; Guangdong Provincial Key Laboratory of Precision Medicine, Clinical and Translational Research in Hakka Population, Meizhou People's Hospital; Guangdong Provincial Engineering and Technology Research Center for Clinical Molecular Diagnostics and Antibody Therapeutics, No. 63 Huangtang Road, Meijiang District, Meizhou, PR China.

Aims: The aim of the present study was to investigate mutation status of the cKit and PDGFRA genes in patients with a gastrointestinal stromal tumor (GIST).

Methods: In total, 96 patients with a GIST were included in the study, in which polymerase chain reaction amplification and gene sequencing were used to detect the sequences of exons 9, 11, 12, 13, 14, 17, and 18 in KIT and exons 12, 14, and 18 in PDGFRA.

Results: KIT mutations were detected in 65 cases (67. Read More

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Lentinan as a natural stabilizer with bioactivities for preparation of drug-drug nanosuspensions.

Int J Biol Macromol 2021 Jun 10;184:101-108. Epub 2021 Jun 10.

School of Chemical Engineering, Sichuan University, Chengdu 610065, China. Electronic address:

Lentinan is a natural β-glucan with various bioactivities and is combined with chemotherapy drugs for cancer treatment. Regorafenib is an oral multi-kinase inhibitor approved by FDA for treatment of metastatic colorectal cancer, advanced hepatocellular carcinoma, and metastatic gastrointestinal stromal tumors. Regorafenib has poor water solubility and multiple toxicities. Read More

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A liver metastasis 7 years after resection of a low-risk duodenal gastrointestinal stromal tumor.

Clin J Gastroenterol 2021 Jun 11. Epub 2021 Jun 11.

Department of Surgery, National Hospital Organization, Higashihiroshima Medical Center, 513 Jike, Saijo-cho, Higashihiroshima, Hiroshima, 739-0041, Japan.

Duodenal gastrointestinal stromal tumors (dGISTs) are rare, and a lack of consensus exists regarding their treatment, particularly for recurrent disease. We herein report a rare case of liver metastasis 7 years after resection of a low-risk duodenal gastrointestinal stromal tumor. A 45-year-old woman revealed positive fecal occult blood. Read More

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Life-threatening haematochezia in a man with two gastrointestinal stromal tumours.

BMJ Case Rep 2021 Jun 9;14(6). Epub 2021 Jun 9.

Internal Medicine, United Arab Emirates University, Al Ain, UAE

A man in his 30s was brought by ambulance to the emergency department with a complaint of frank bright red rectal bleeding and dizziness. His blood pressure was 60/18 mm Hg. He was resuscitated with intravenous normal saline and an emergency blood transfusion. Read More

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Hereditary inflammatory fibroid polyps caused by germline pathogenic variants in PDGFRA: Refining PDGFRA-mutation syndrome.

Cancer Genet 2021 May 24;256-257:106-109. Epub 2021 May 24.

Cancer Genetics and Genomics, Stanford Health Care, United States; Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, United States.

A 35-year-old Filipino woman presented with epigastric pain and was found to have two large jejunal and ileal inflammatory fibroid polyps (IFPs) and dozens of subcentimeter small bowel submucosal nodules. Targeted exon sequencing of PDGFRA on the resected jejunum IFP identified a variant c.1664A>G that was subsequently confirmed in the germline. Read More

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Curative intent treatment of late presented extragastrointestinal stromal tumor: two identical case reports with literature review.

J Surg Case Rep 2021 Jun 4;2021(6):rjab220. Epub 2021 Jun 4.

Department of General Surgery, Scheer Memorial Adventist Hospital, Banepa, Nepal.

Gastrointestinal stromal tumors (GISTs) occurring outside the gastrointestinal tract are known as extragastrointestinal stromal tumors (EGIST). They share some common histopathologic and molecular characteristics. This report describes two female patients who were suspected of having a mesenteric GIST, but opted for surveillance rather than definitive treatment. Read More

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Value of radiomics model based on enhanced computed tomography in risk grade prediction of gastrointestinal stromal tumors.

Sci Rep 2021 Jun 8;11(1):12009. Epub 2021 Jun 8.

Department of Radiology, Jiangxi Provincial People's Hospital Affiliated to Nanchang University, Nanchang, 330006, China.

To explore the application of computed tomography (CT)-enhanced radiomics for the risk-grade prediction of gastrointestinal stromal tumors (GIST). GIST patients (n = 292) confirmed by surgery or endoscopic pathology during June 2013-2019 were reviewed and categorized into low-grade (very low to low risk) and high-grade (medium to high risk) groups. The tumor region of interest (ROI) was depicted layer by layer on each patient's enhanced CT venous phase images using the ITK-SNAP. Read More

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KIT Mutation in Gastric Gastrointestinal Stromal Tumor in a Patient With Familial Paraganglioma Syndrome Type 4.

AACE Clin Case Rep 2021 May-Jun;7(3):174-176. Epub 2021 Jan 7.

Department of Medicine, Queen's University, Kingston, Ontario, Canada.

Objective: Familial paraganglioma syndrome type 4 is associated with mutations in the succinate dehydrogenase complex subunit B (SDHB) gene. We report the case of a patient with familial paraganglioma syndrome type 4 with the mutation c.600G>T; p. Read More

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January 2021

Imatinib-resistant gastrointestinal stromal tumors in the era of second- and third-line tyrosine kinase inhibitors: Does surgical resection have a role?

Surgery 2021 Jun 2. Epub 2021 Jun 2.

The Knight Cancer Institute at Oregon Health & Science University, Portland, OR; Department of Surgery, Division of Surgical Oncology, Oregon Health & Science University, Portland, OR. Electronic address:

Background: Imatinib resistance is associated with a poor prognosis in patients with gastrointestinal stromal tumors. Although novel tyrosine kinase inhibitors have improved outcomes in imatinib-resistant gastrointestinal stromal tumors, the role of resection remains unclear. We sought to investigate factors predictive of overall and progression-free survival in patients with imatinib-resistant gastrointestinal stromal tumors. Read More

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Starting Imatinib at 400 mg Daily in Patients with Gastrointestinal Stromal Tumors Harboring KIT Exon 9 Mutations: A Retrospective, Multicenter Study.

Target Oncol 2021 Jun 5. Epub 2021 Jun 5.

Department of Cancer Medicine, Gustave Roussy, Villejuif, France.

Background: Retrospective analyses suggest that patients with advanced KIT exon 9-mutated gastrointestinal stromal tumors (GISTs) receiving imatinib 800 mg (rather than 400 mg) daily have better outcomes. In the adjuvant setting, the question of the optimal dose of imatinib remains unsettled.

Objective: We aimed to retrospectively assess the activity of imatinib 400 mg in both the adjuvant and the advanced settings. Read More

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An Integrated Epigenome and Transcriptome Analysis to Clarify the Effect of Epigenetic Inhibitors on GIST.

Anticancer Res 2021 Jun;41(6):2817-2828

Department of Molecular Biology, Sapporo Medical University School of Medicine, Sapporo, Japan;

Background/aim: Epigenetic alterations play an important role in the pathogenesis of gastrointestinal stromal tumors (GISTs). To obtain further insight into the GIST epigenome, we analyzed genome-wide histone modification and DNA methylation in GIST cells.

Materials And Methods: To reverse epigenetic silencing, GIST-T1 cells were treated with a DNA methyltransferase inhibitor and a histone deacetylase inhibitor, and subsequently H3K4me3 levels, the DNA methylome, and the transcriptome were analyzed. Read More

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Current treatment and outcomes of pediatric gastrointestinal stromal tumors (GIST): a systematic review of published studies.

Pediatr Surg Int 2021 Jun 3. Epub 2021 Jun 3.

Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, University of Liverpool, Eaton Road, Liverpool, L12 2AP, UK.

Gastrointestinal stromal tumor (GIST) is a rare cancer of mesenchymal origin mostly seen in adult and elderly populations. Therefore, the prognostic and therapeutic features of pediatric GIST are not clearly defined. Clinical knowledge has been largely extrapolated from case series and adult studies. Read More

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Utility of noncontrast MRI in the detection and risk grading of gastrointestinal stromal tumor: a comparison with contrast-enhanced CT.

Quant Imaging Med Surg 2021 Jun;11(6):2453-2464

Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

Background: Recently developed adjuvant therapies for gastrointestinal stromal tumor (GIST) have been shown to improve patient survival. Guidelines currently recommend contrast-enhanced computed tomography (CECT) for GIST detection and surveillance. Patients with moderate-to-high risk GISTs require more frequent surveillance due to a higher 5-year recurrence rate. Read More

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Preoperative C-Reactive Protein/Albumin Ratio is a Prognostic Indicator for Survival in Surgically Treated Gastrointestinal Stromal Tumors: A Retrospective Cohort Study.

Cancer Manag Res 2021 24;13:4155-4167. Epub 2021 May 24.

Department of Gastrointestinal Surgery, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.

Background: Systemic inflammation and malnutrition may promote tumor progression. C-reactive protein/albumin ratio (CAR) is linked to the poor long-term survival of several malignant tumors.

Purpose: To explore the predictive value of CAR in gastrointestinal stromal tumors (GISTs). Read More

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[Gastric SWI/SNF-complex deficient undifferentiated/rhabdoid carcinoma: a clinicopathological study].

Zhonghua Bing Li Xue Za Zhi 2021 Jun;50(6):632-637

Department of Pathology, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical School, Fudan University, Shanghai 200032, China.

To investigate the clinicopathological features, immunohistochemical characteristics, differential diagnosis and prognosis of gastric SWI/SNF-complex deficient undifferentiated/rhabdoid carcinomas. Two cases of gastric SWI/SNF-complex deficient undifferentiated/rhabdoid carcinoma were collected at Fudan University Shanghai Cancer Center, Shanghai, China from 2017 to 2018. The clinicopathological characteristics were analyzed. Read More

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A Nomogram Predicting Progression Free Survival in Patients with Gastrointestinal Stromal Tumor Receiving Sunitinib: Incorporating Pre-Treatment and Post-Treatment Parameters.

Cancers (Basel) 2021 May 25;13(11). Epub 2021 May 25.

Department of Surgery and GIST Team, Chang Gung Memorial Hospital at Linkou, ChangGung University College of Medicine, Taoyuan 33305, Taiwan.

The present study aimed to construct a prognostic nomogram incorporating pre-treatment and post-treatment factors to predict progression-free survival (PFS) after use of sunitinib in patients with metastatic gastrointestinal stromal tumors (GISTs) following imatinib intolerance or failure. From 2007 to 2018, 109 metastatic GIST patients receiving sunitinib at Chang Gung Memorial Hospital, Taiwan, were enrolled. A prognostic nomogram to predict PFS was developed. Read More

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Second Primary Tumors in Patients with Gastrointestinal Stromal Tumors: A Single-Center Experience.

Medicina (Kaunas) 2021 May 13;57(5). Epub 2021 May 13.

Department of Biostatistics and Medical Informatics, Süleyman Demirel University Faculty of Medicine, Isparta 32260, Turkey.

: In this study, we investigated the frequency and type of second primary malignant tumors (SPMTs) accompanying gastrointestinal stromal tumors (GISTs), patient and tumor characteristics, and follow-up and survival data. : We included 20 patients with SPMTs from a total of 103 patients with GISTs in a single center in Turkey. At the time of GIST diagnosis, patient age, sex, presentation symptoms, localization, pathological features of the tumor, stage, recurrence risk scoring for localized disease, treatments received, time of SPMT association, follow-up times, and survival analysis were recorded for each patient. Read More

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ASO Visual Abstract: National Utilization of Imatinib in the Management of Resected Gastrointestinal Stromal Tumors.

Ann Surg Oncol 2021 May 28. Epub 2021 May 28.

Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

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Laparoscopic vs Open Resection of Gastrointestinal Stromal Tumors (GISTs) from Gastric Origin: different approaches for different diseases.

Minerva Surg 2021 May 28. Epub 2021 May 28.

Department of Digestive Surgery, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.

Background: Although minimally invasive techniques are currently recognized as effective and validated treatment for small gastric gastrointestinal stromal tumors (GISTs), the role of laparoscopy is not yet established. The aim of this study was to evaluate the outcomes of laparoscopic treatment of gastric GISTs compared to the results obtained in a group of patients treated with conventional surgery.

Methods: A retrospective analysis was performed, using a prospectively maintained comprehensive database of 100 patients treated for gastric GIST in the period from 2000 to 2015. Read More

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National Utilization of Imatinib in the Management of Resected Gastrointestinal Stromal Tumors.

Ann Surg Oncol 2021 May 27. Epub 2021 May 27.

Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

Background: Imatinib decreases recurrence risk and improves overall survival (OS) in localized gastrointestinal stromal tumors (GISTs); however, the extent to which patients receive appropriate treatment in the US has not been well characterized.

Methods: Patients with non-metastatic, resectable GIST were included in this study (National Cancer Database, 2010-2015). Those with a low-risk of recurrence were classified as receiving overtreatment or guideline-concordant treatment, while those with a high-risk of recurrence were classified as receiving undertreatment or guideline-concordant treatment. Read More

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Single-Incision Laparoscopic Intragastric Surgery for Gastric Submucosal Tumors Located Near the Esophagogastric Junction.

J Laparoendosc Adv Surg Tech A 2021 May 27. Epub 2021 May 27.

Department of Gastrointestinal Surgery, the Li Huili Affiliated Hospital, Ningbo University, Ningbo, Zhejiang Province, China.

Laparoscopic local resection of the stomach for gastric submucosal tumors (SMTs) is widely accepted by surgeons. For SMTs located near the esophagogastric junction (EGJ), simple laparoscopic wedge resection is rarely performed owing to concerns of causing cardia deformities or stenosis. Single-incision laparoscopic intragastric surgery (sLIGS) has been used to treat SMTs located near the EGJ in carefully selected cases. Read More

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MRI-Based Radiomics Models for Predicting Risk Classification of Gastrointestinal Stromal Tumors.

Front Oncol 2021 10;11:631927. Epub 2021 May 10.

Department of Radiology, Shaoxing People's Hospital, Shaoxing Hospital, Zhejiang University School of Medicine, Shaoxing, China.

Background: We conduct a study in developing and validating four MRI-based radiomics models to preoperatively predict the risk classification of gastrointestinal stromal tumors (GISTs).

Methods: Forty-one patients (low-risk = 17, intermediate-risk = 13, high-risk = 11) underwent MRI before surgery between September 2013 and March 2019 in this retrospective study. The Kruskal-Wallis test with Bonferonni correction and variance threshold was used to select appropriate features, and the Random Forest model (three classification model) was used to select features among the high-risk, intermediate-risk, and low-risk of GISTs. Read More

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Plexiform fibromyxoma: Review of rare mesenchymal gastric neoplasm and its differential diagnosis.

World J Gastrointest Oncol 2021 May;13(5):409-423

Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY 12208, United States.

Plexiform fibromyxoma (PF) is a very rare mesenchymal neoplasm of the stomach that was first described in 2007 and was officially recognized as a subtype of gastric mesenchymal neoplasm by World Health Organization (WHO) in 2010. Histologically, PF is characterized by a plexiform growth of bland spindle to ovoid cells embedded in a myxoid stroma that is rich in small vessels. The lesion is usually paucicellular. Read More

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Small bowel GIST with hemorrhagic shock diagnosed by capsule endoscopy and double-balloon endoscopy, angiography-guided hemostasis, and laparoscopic-assisted resection.

Clin Case Rep 2021 May 15;9(5):e04240. Epub 2021 May 15.

Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery Nippon Medical School Tokyo Japan.

Small bowel tumors presenting with hemorrhagic shock require urgent treatment with angiographic embolization to achieve hemostasis. Capsule endoscopy and double-balloon endoscopy are useful for localizing the tumor, diagnosis, and guiding surgery. Read More

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Proteasome Inhibition Suppresses KIT-Independent Gastrointestinal Stromal Tumors Via Targeting Hippo/YAP/Cyclin D1 Signaling.

Front Pharmacol 2021 6;12:686874. Epub 2021 May 6.

Zhejiang Provincial Key Laboratory of Silkworm Bioreactor and Biomedicine, College of Life Sciences and Medicine, Zhejiang Sci-Tech University, Hangzhou, China.

Gastrointestinal stromal tumors (GISTs) are the most common malignant tumor of mesenchymal origin of the digestive tract. A yet more challenging resistance mechanism involves transition from oncogenic KIT to a new imatinib-insensitive oncogenic driver, heralded by loss of KIT expression. Our recent studies have shown that inhibition of cyclin D1 and Hippo signaling, which are overexpressed in KIT-independent GIST, is accompanied by anti-proliferative and apoptosis-promoting effects. Read More

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Primary Extragastrointestinal Stromal Tumor of Greater Omentum with Intraperitoneal Bleeding: A Case Report.

Intern Med 2021 May 22. Epub 2021 May 22.

Department of Internal Medicine II, Shimane University Faculty of Medicine, Japan.

Gastrointestinal stromal tumors (GISTs) develop in the digestive tract, mainly in the stomach, small intestine, colon, or esophagus. However, primary tumors with the same pathologic features as GISTs have been reported to occur outside of the digestive tract and are called extragastrointestinal stromal tumor (EGIST). We herein report a rare case of EGIST arising from the greater omentum in a patient with abdominal pain caused by intraperitoneal bleeding from the tumor. Read More

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Quantitative proteomic analysis of aberrant expressed lysine acetylation in gastrointestinal stromal tumors.

Clin Proteomics 2021 May 22;18(1):16. Epub 2021 May 22.

Laboratory of Surgical Oncology, Peking University People's Hospital, Beijing, People's Republic of China.

Background: Gastrointestinal stromal tumor (GIST) is a common digestive tract tumor with high rate of metastasis and recurrence. Currently, we understand the genome, transcriptome and proteome in GIST. However, posttranscriptional modification features in GIST remain unclear. Read More

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Gastrointestinal stromal tumor metastasis to the ovary: A case report.

SAGE Open Med Case Rep 2021 29;9:2050313X211012511. Epub 2021 Apr 29.

Department of Gastroenterological Surgery and Division of Cancer Medicine, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.

Gastrointestinal stromal tumors are common mesenchymal tumors of the gastrointestinal tract. The major site of metastasis for gastrointestinal stromal tumors is the liver or peritoneum, while metastasis to the ovary is exceptionally rare. A 53-year-old woman visited the hospital for bloating and anorexia and was diagnosed with a huge gastric gastrointestinal stromal tumor and peritoneal metastasis in the pelvis on upper gastrointestinal endoscopy and abdominal enhanced computed tomography. Read More

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