Ann Dermatol.  2018 Jun;30(3):345-347. 10.5021/ad.2018.30.3.345.

Metastatic Cutaneous Duodenal Gastrointestinal Stromal Tumor: A Possible Clue to Multiple Metastases

Affiliations
  • 1Department of Dermatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. miumiu@amc.seoul.kr

Abstract

We report a case of a 69-year-old man with metastatic cutaneous duodenal gastrointestinal stromal tumor, which led to find multiple metastases on orbital muscle and scalp. The patient presented with a rapidly growing chest nodule with mild tenderness. He underwent surgical resection for duodenal gastrointestinal stromal tumor and had been treated with imatinib for three years. Histopathological examination of the chest nodule was consistent with gastrointestinal stromal tumor. A brain magnetic resonance imaging of follow work-up revealed multiple metastases at the left superior rectus muscle and occipital scalp. Under the diagnosis with imatinib-resistant duodenal gastrointestinal stromal tumors, a second-line therapy with sunitinib was tried. After six weeks, his skin lesion was completely improved and other metastatic cancers showed a response of stable disease. This is the first reported case of a cutaneous metastasis from duodenal GIST. This report emphasizes the importance of a full-skin examination in patients with a medical history of gastrointestinal stromal tumor which leads to find multiple metastases.

Keyword

Duodenum; Gastrointestinal stromal tumors; Neoplasm metastasis; Skin

MeSH Terms

Aged
Brain
Diagnosis
Duodenum
Gastrointestinal Stromal Tumors*
Humans
Imatinib Mesylate
Magnetic Resonance Imaging
Neoplasm Metastasis*
Orbit
Scalp
Skin
Thorax
Imatinib Mesylate

Figure

  • Fig. 1 A solitary, 15×15 mm-sized, firm, skin-colored, round tender nodule on chest.

  • Fig. 2 (A) Tumor mass showing solitary sharply demarcated subcutaneous mass (H&E, ×12.5). (B, C) A slightly spindled and epithelioid atypical tumor cells with pleomorphic nuclei and multiple mitoses (H&E, ×100, ×400). (D, E) Positive reactivity for high molecular weight CD117 (D) and DOG-1 (E) (×100).


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