Unusual bilateral ovarian metastases from ileal gastrointestinal stromal tumor (GIST): a case report

Antonio De Leo,Pierandrea De Iaco,Milena Urbini,Maria Abbondanza Pantaleo,Elisa Gruppioni,Margherita Nannini,Anna Myriam Perrone,Giulia Dondi,Donatella Santini

doi:10.1186/s12885-018-4204-1

Antonio De Leo, Pierandrea De Iaco + Show 7 more

Open Access

https://doi.org/10.1186/s12885-018-4204-1

Copy DOI

Journal: BMC Cancer	Publication Date: Mar 16, 2018
Citations: 6	License type: open-access

Affiliation: University of Bologna, Policlinico S.Orsola-Malpighi

Abstract

BackgroundGastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract and liver and peritoneum are the main sites of recurrence. Ovarian metastases from GIST are very rare.Case PresentationA 50 years-old woman was found to have a pelvic mass on transvaginal ultrasound (TV-US) and computed tomography (CT)-scan, considered as a right ovarian mass. The patient underwent surgical abdominal exploration that showed an ileal mass, a normal right ovary and an irregular and vascularized surface of the left ovary. A segmental ileal resection and an ileal anastomosis were performed. Frozen section showed a GIST and surgery was completed with hysterectomy, bilateral salpingo-oophorectomy, pelvic peritonectomy, peritoneal washing and Burch procedure. The histological examination confirmed an ileal GIST with ovarian metastases, harboring in both sites of disease a KIT exon 11 deletion.ConclusionsOvarian localizations, as far as rare, can be a clinical finding in case of ileal GIST patients, and both gynecologists, pathologists and medical oncologists should be able to recognize them.

Highlights

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract and liver and peritoneum are the main sites of recurrence
We reported a case of GIST patient, presenting ovarian metastases at the onset of disease
Given the rarity of this unusual presentation, we retrospectively reviewed the clinical cases of our institutional reference center for GIST and among 224 female patients collected from 2001, we found only another case of GIST patient with synchronous ovarian metastases who was managed at the time of diagnosis in another center

Summary

Introduction

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal tumors of the gastrointestinal tract and liver and peritoneum are the main sites of recurrence. Ovarian metastases from GIST have been previously described only in five cases in a series [9]. We report a case of GIST patient presenting bilateral ovarian metastases at the onset of disease, highlighting the pathological/molecular features of this unusual site of metastatic presentation and the clinical implications.

Results

Conclusion