TY - JOUR
T1 - Cutaneous and subcutaneous metastases of gastrointestinal stromal tumors
T2 - A series of 5 cases with molecular analysis
AU - Wang, Wei Lien
AU - Hornick, Jason L.
AU - Mallipeddi, Raj
AU - Zelger, Bettina G.
AU - Rother, Joshua D.
AU - Yang, Dan
AU - Lev, Dina C.
AU - Trent, Jonathan C.
AU - Prieto, Victor G.
AU - Brenn, Thomas
AU - Calonje, Eduardo
AU - Lazar, Alexander J.F.
PY - 2009/5
Y1 - 2009/5
N2 - Gastrointestinal stromal tumors (GISTs) rarely metastasize to the skin. We describe 5 patients with GIST with subcutaneous and cutaneous metastases. The mean age at metastasis was 54 years (range 30-68 years) with a male predominance (4:1). Primary tumors occurred in the stomach (n = 3), small bowel (n = 1), and abdomen, not otherwise specified (n = 1). The average time from primary tumor resection to the resection of skin metastases was 59 months (range 11-155 months). The metastases occurred in the scalp (n = 2), cheek (n = 1), and abdomen (n = 2) with 3 patients presenting with solitary nodules and 2 patients with multiple nodules. The average size was 2 cm (range 0.6-4 cm). Histologically, 2 cases were spindled and 3 cases demonstrated mixed epithelioid and spindle cell morphology. All were confirmed to have CD117 reactivity. KIT genotyping was performed in 4 of 5 cases. Two cases harbored a mutation in exon 11, and the remaining 2 cases were wild type in exons 9, 11, 13, and 17. All 5 patients had multiple concurrent or subsequent abdominal and/or hepatic metastases. In 4 patients with an average follow-up of 32 months (range 6-75 months), after the resection of the metastases, 2 were alive with disease and 2 died of disease. Cutaneous metastases seem to be a late complication of GIST, but their presence does not necessarily herald a rapid demise of the patient.
AB - Gastrointestinal stromal tumors (GISTs) rarely metastasize to the skin. We describe 5 patients with GIST with subcutaneous and cutaneous metastases. The mean age at metastasis was 54 years (range 30-68 years) with a male predominance (4:1). Primary tumors occurred in the stomach (n = 3), small bowel (n = 1), and abdomen, not otherwise specified (n = 1). The average time from primary tumor resection to the resection of skin metastases was 59 months (range 11-155 months). The metastases occurred in the scalp (n = 2), cheek (n = 1), and abdomen (n = 2) with 3 patients presenting with solitary nodules and 2 patients with multiple nodules. The average size was 2 cm (range 0.6-4 cm). Histologically, 2 cases were spindled and 3 cases demonstrated mixed epithelioid and spindle cell morphology. All were confirmed to have CD117 reactivity. KIT genotyping was performed in 4 of 5 cases. Two cases harbored a mutation in exon 11, and the remaining 2 cases were wild type in exons 9, 11, 13, and 17. All 5 patients had multiple concurrent or subsequent abdominal and/or hepatic metastases. In 4 patients with an average follow-up of 32 months (range 6-75 months), after the resection of the metastases, 2 were alive with disease and 2 died of disease. Cutaneous metastases seem to be a late complication of GIST, but their presence does not necessarily herald a rapid demise of the patient.
KW - Cutaneous
KW - GIST
KW - Gastrointestinal stromal tumor
KW - Metastasis
KW - Skin
UR - http://www.scopus.com/inward/record.url?scp=66149109140&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=66149109140&partnerID=8YFLogxK
U2 - 10.1097/DAD.0b013e31818acb1a
DO - 10.1097/DAD.0b013e31818acb1a
M3 - Article
C2 - 19384074
AN - SCOPUS:66149109140
SN - 0193-1091
VL - 31
SP - 297
EP - 300
JO - American Journal of Dermatopathology
JF - American Journal of Dermatopathology
IS - 3
ER -