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01-07-2017 | Original Article

Clinical and pathological characteristics of gastrointestinal stromal tumor (GIST) metastatic to bone

Authors: Kemal Kosemehmetoglu, Gulsah Kaygusuz, Karen Fritchie, Ovgu Aydin, Ozlem Yapicier, Oznur Coskun, Ersin Karatayli, Senay Boyacigil, Gulnur Guler, Sergulen Dervisoglu, Isinsu Kuzu

Published in: Virchows Archiv | Issue 1/2017

Abstract

Our aim in this study was to describe the clinical, morphological, and molecular profile of gastrointestinal stromal tumor (GIST) metastatic to bone. We analyzed the morphological, phenotypic, and molecular characteristics of seven cases, and in addition reviewed 17 cases from literature. Sequence analysis of KIT and PDGFRA genes was possible for six cases. For the GIST cases with bone metastasis, the most common primaries were small intestine (29%), stomach (25%), and rectum (21%). Sites of bone metastases were vertebrae (11), pelvis (8), femur (8), ribs (6), humerus (5), skull (3), scapula (1), and mandible (1). The size ranged from 1.5 to 13 cm (median, 3.8 cm). Bone metastases without involvement of any other organ were seen in 17% of the cases and were solitary in 14 (58%). Adjacent soft tissue involvement was present in nearly half of the patients. Bone metastasis was either manifest at the time of diagnosis (28%) or occurred after a mean period of 4.7 years (3 months–20 years). Morphologically, neoplastic cells were spindle in 67%, epithelioid in 13%, and mixed epithelioid and spindle in 20%. CD117, DOG1, and CD34 were positive in 88, 86, and 85% of the cases, respectively. KIT Exon 11 mutations were the most frequent gene alteration (78%), followed by KIT Exon 13 mutations. Of 17 of the cases with available follow-up information, 7 (41%) patients developed bone metastasis under imatinib therapy. Five patients (29%) died of disease within a mean of 17 months. Bone metastases from GIST are usually found in patients with advanced disease and typically present as lytic masses with occasional soft tissue involvement. We could not identify any KIT or PDGFRA alterations predisposing to bone metastasis.

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Title: Clinical and pathological characteristics of gastrointestinal stromal tumor (GIST) metastatic to bone
Authors: Kemal Kosemehmetoglu
Gulsah Kaygusuz
Karen Fritchie
Ovgu Aydin
Ozlem Yapicier
Oznur Coskun
Ersin Karatayli
Senay Boyacigil
Gulnur Guler
Sergulen Dervisoglu
Isinsu Kuzu
Publication date: 01-07-2017
Publisher: Springer Berlin Heidelberg
Published in: Virchows Archiv / Issue 1/2017
Print ISSN: 0945-6317
Electronic ISSN: 1432-2307
DOI: https://doi.org/10.1007/s00428-017-2138-7

At a glance: The STEP trials

Springer Medicine

Clinical and pathological characteristics of gastrointestinal stromal tumor (GIST) metastatic to bone

Abstract

At a glance: The STEP trials

Springer Medicine

Abstract

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