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Journal of Nippon Medical School

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-Case Reports-

Pancreatic Metastasis from Gastrointestinal Stromal Tumor of the Stomach: A Case Report

Nobutoshi Hagiwara1, Takeshi Matsutani1, Tsutomu Nomura1, Itsuo Fujita1, Yoshikazu Kanazawa1, Junji Ueda1, Hiroki Arai1, Daisuke Kakinuma1, Hitoshi Kanno1, Zenya Naito2 and Eiji Uchida1

1Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Graduate School of Medicine, Tokyo, Japan
2Department of Pathology and Integrative Oncological Pathology, Nippon Medical School, Graduate School of Medicine, Tokyo, Japan


We report the first documented case of pancreatic metastasis from a gastrointestinal stromal tumor of the stomach. A 42-year-old Japanese man presented with severe abdominal discomfort. Computed tomography of the abdomen showed a huge heterogeneous mass consisting of cystic and solid components in the left upper abdomen. 18F-Fluorodeoxyglucose positron-emission tomography revealed high tracer uptake in the abdominal mass. After total gastrectomy with lymphnodectomy was performed, a hard mass was palpated in the pancreatic tail. The pancreatic tumor was also resected under the therapeutic strategy. Histological examinations of the resected gastric and pancreatic specimens revealed that both tumors consisted of uniform spindle cells with a fascicular growth pattern and were immunohistochemically positive for CD34 and CD117/KIT. Gene sequencing analysis of DNA from each tumor revealed an identical deletion of 21 nucleotides in exon 11 of the gene KIT. On the basis of these results, we concluded that the pancreatic tumor was a metastatic tumor from the gastrointestinal stromal tumor of the stomach.

J Nippon Med Sch 2016; 83: 133-138

Keywords
gastrointestinal stromal tumor, stomach, pancreatic metastasis, gene sequencing analysis

Correspondence to
Nobutoshi Hagiwara, Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Graduate School of Medicine, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
hagi@nms.ac.jp

Received, October 25, 2015
Accepted, February 3, 2016