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Open Access Highly Accessed Case Report

Subsequent intra-abdominal fibromatosis mimicking recurrent gastrointestinal stromal tumor

Dongxian Jiang1, Deming He1, Yingyong Hou1*, Weiqi Lu2*, Yuan Shi1, Qin Hu1, Shaohua Lu1, Chen Xu1, Yalan Liu1, Ju Liu1, Yunshan Tan1 and Xiongzeng Zhu3

Author Affiliations

1 Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China

2 Department of Oncology Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, P.R. China

3 Department of Pathology, Cancer hospital, Fudan University, Shanghai 200032, P.R. China

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Diagnostic Pathology 2013, 8:125  doi:10.1186/1746-1596-8-125

Published: 31 July 2013

Abstract

Intra-abdominal fibromatosis (IAF) commonly develops in patients who had abdominal surgery. In rare instances, it occurs subsequent to gastrointestinal stromal tumor (GIST). This special situation has clinical significance in imatinib era. About 1000 patients with GIST in our institution from 1993 to 2010 were re-evaluated based on their clinical and pathological data, the treatment strategies and the follow-up information. We identified 2 patients who developed IAF after GIST resection. Patient 1 was a 54 year-old male and had 5 cm × 4.5 cm × 3.5 cm jejunal GIST excised on February 22, 1994. Three years later, an abdominal mass with 7 cm × 6 cm × 3 cm was identified. He was diagnosed as recurrent GIST from clinical point of view. After excision, the second tumor was confirmed to be IAF. Patient 2 was a 45-year-old male and had 6 cm × 4 cm × 3 cm duodenal GIST excised on August 19, 2008. One year later, a 4 cm mass was found at the original surgical site. The patient refused to take imatinib until the tumor increased to 8 cm six months later. The tumor continued to increase after 6 months’ imatinib therapy, decision of surgical resection was made by multidisciplinary team. The second tumor was confirmed to be IAF with size of 17 cm × 13 cm × 11 cm. Although IAF subsequent to GIST is very rare, it is of clinical significance in imatinib era as an influencing factor for making clinical decision.

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1076715989961803 webcite

Keywords:
GIST; Intra-abdominal fibromatosis (IAF); Imatinib