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Synchronous colorectal adenocarcinoma and gastrointestinal stromal tumor (GIST)

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Abstract

Background

Little is known about the synchronous occurrence of gastrointestinal stromal tumors (GISTs) and other gastrointestinal tumors. We present two cases of an invasive colon cancer with a synchronous small-bowel GIST; immunohistochemistry studies were performed to evaluate possible genetic similarities.

Methods

This paper reports two cases of synchronous GISTs and colorectal cancer (CRC) with immunohistochemistry analysis of c-Kit expression. This paper is also a review of the existing literature on the association of GISTs and CRC and the role of c-Kit in CRC.

Results

In the last 2 years, we observed two patients with synchronous CRCs and GISTs of the small bowel. The GISTs were incidentally discovered during the work-up for CRCs and excised at the time of the colon resection. Immunohistochemistry study did not reveal an expression of c-Kit in CRCs. Clinical implications of the association between these two neoplasms are described in this paper.

Conclusions

Synchronous CRC and GIST has been more frequently reported. Because of the limited number of cases, we cannot exclude an incidental relationship. The genetic pathways of tumorigenesis appear different for the two neoplasms. Further studies are needed to clarify a possible role of c-Kit in the development of colonic adenocarcinomas.

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References

  1. Mazur MT, Clark HB (1983) Gastric stromal tumors. Reappraisal of histogenesis. Am J Surg Pathol 7:507–519

    Article  PubMed  CAS  Google Scholar 

  2. Kindblom LG, Remotti HE, Aldenborg F, Meis-Kindblom JM (1998) Gastrointestinal pacemaker cell tumor (GIPACT): gastrointestinal stromal tumors show phenotypic characteristics of the interstitial cells of Cajal. Am J Pathol 152:1259–1269

    PubMed  CAS  Google Scholar 

  3. Hirota S, Isozaki K, Moriyama Y, Hashimoto K, Nishida T, Ishiguro S, Kawano K, Hanada M, Kurata A, Takeda M, Muhammad Tunio G, Matsuzawa Y, Kanakura Y, Shinomura Y, Kitamura Y (1998) Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science 279:577–580

    Article  PubMed  CAS  Google Scholar 

  4. Rossi CR, Mocellin S, Mencarelli R, Foletto M, Pilati P, Nitti D, Lise M (2003) Gastrointestinal stromal tumors: from a surgical to a molecular approach. Int J Cancer 107:171–176

    Article  PubMed  CAS  Google Scholar 

  5. Greene FL, Page DL, Fleming ID, Fritz AG, Balch CM, Haller DG, Morrow M (2002) AJCC cancer staging manual, 6th edn. Springer, Berlin Heidelberg New York, pp 113–123

    Google Scholar 

  6. Kover E, Faluhelyi Z, Bogner B, Kalmar K, Horvath G, Tornoczky T (2004) Dual tumours in the GI tract: synchronous and metachronous stromal (GIST) and epithelial/neuroendocrine neoplasms. Magy Onkol 48:315–321

    PubMed  Google Scholar 

  7. Au WY, Ho KM, ShekTW (2004) Papillary renal cell carcinoma and gastrointestinal stromal tumor: a unique association. Ann Oncol 15:843–844

    Article  PubMed  CAS  Google Scholar 

  8. DeMatteo RP, Brennan MF (2004) Gastrointestinal stromal tumors. In: Cameron JL (ed) Current surgical therapy, 8th edn. Elsevier Mosby, Philadelphia, pp 100–103

    Google Scholar 

  9. Welton ML, Varma MG, Amerhouser A (2001). Colon, rectum, and anus. In: Norton JA, Bollinger RR, Chang AE, Lowry SF, Mulvihill SJ, Pass HJ, Thompson RW (eds) Surgery: basic science and clinical evidence. Springer, Berlin Heidelberg New York, pp 667–762

    Google Scholar 

  10. Hahn M, Koufaki ON, Schackert HK (1998) Molecular biology of colorectal cancer and clinical consequences for colorectal cancer syndromes. Langenbecks Arch Surg 383:389–396

    Article  PubMed  CAS  Google Scholar 

  11. Linnekin D (1999) Early signaling pathways activated by c-Kit in hematopoietic cells. Int J Biochem Cell Biol 31:1053–1074

    Article  PubMed  CAS  Google Scholar 

  12. Sammarco I, Capurso G, Coppola L, Bonifazi AP, Cassetta S, Delle Fave G, Carrara A, Grassi GB, Rossi P, Sette C, Geremia R (2004) Expression of the proto-oncogene c-KIT in normal and tumor tissues from colorectal carcinoma patients. Int J Colorectal Dis 19:545–553

    Article  PubMed  Google Scholar 

  13. Bellone G, Carbone A, Sibona N, Bosco O, Tibaudi D, Smirne C, Martone T, Gramigni C, Camandona M, Emanuelli G, Rodeck U (2001) Aberrant activation of c-kit protects colon carcinoma cells against apoptosis and enhances their invasive potential. Cancer Res 61:2200–2206

    PubMed  CAS  Google Scholar 

  14. Attoub S, Rivat C, Rodrigues S, Van Bocxlaer S, Bedin M, Bruyneel E, Louvet C, Kornprobst M, Andre T, Mareel M, Mester J, Gespach C (2002) The c-Kit tyrosine kinase inhibitor STI571 for colorectal cancer therapy. Cancer Res 62:4879–4883

    PubMed  CAS  Google Scholar 

  15. Toyota M, Hinoda Y, Takaoka A, Makiguchi Y, Takahashi T, Itoh F, Imai K, Yachi A (1993) Expression of c-kit and kit ligand in human colon carcinoma cells. Tumour Biol 14:295–302

    Article  PubMed  CAS  Google Scholar 

  16. Singer CF, Hudelist G, Lamm W, Mueller R, Czerwenka K, Kubista E (2004) Expression of tyrosine kinases in human malignancies as potential targets for kinase-specific inhibitors. Endocr Relat Cancer 11:861–869

    Article  PubMed  CAS  Google Scholar 

  17. Reed J, Ouban A, Schickor FK, Muraca P, Yeatman T, Coppola D (2002) Immunohistochemical staining for c-kit (CD117) is a rare event in human colorectal carcinoma. Clin Colorectal Cancer 2:119–122

    PubMed  Google Scholar 

  18. DeMatteo RP, Lewis JJ, Leung D, Mudan SS, Woodruff JM, Brennan MF (2000) Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival. Ann Surg 231:51–58

    Article  PubMed  CAS  Google Scholar 

  19. Pierie J, Choudry U, Muzikansky A, Yeap B, Souba W, Ott M (2001) The effect of surgery and grade on outcome of gastrointestinal stromal tumors. Arch Surg 136:383–389

    Article  PubMed  CAS  Google Scholar 

  20. Pidhorecky I, Cheney RT, Kraybill WG, Gibbs JF (2000) Gastrointestinal stromal tumors: current diagnosis, biologic behavior, and management. Ann Surg Oncol 7:705–712

    Article  PubMed  CAS  Google Scholar 

  21. McGrath PC, Neifeld JP, Lawrence W, Kay S, Horsley JS 3rd, Parker GA (1987) Gastrointestinal sarcomas. Analysis of prognostic factors. Ann Surg 206:706–710

    Article  PubMed  CAS  Google Scholar 

  22. Dougherty MJ, Compton C, Talbert M, Wood WC (1991) Sarcomas of the gastrointestinal tract. Separation into favorable and unfavorable prognostic group by mitotic count. Ann Surg 214:569–574

    Article  PubMed  CAS  Google Scholar 

  23. Conlon KC, Casper ES, Brennan MF (1995) Primary gastrointestinal sarcomas: analysis of prognostic variables. Ann Surg Onc 2:26–31

    Article  CAS  Google Scholar 

  24. Demetri GD, von Mehren M, Blanke CD, Van den Abbeele AD, Eisenberg B, Roberts PJ, Heinrich MC, Tuveson DA, Singer S, Janicek M, Fletcher JA, Silverman SG, Silberman SL, Capdeville R, Kiese B, Peng B, Dimitrijevic S, Druker BJ, Corless C, Fletcher CD, Joensuu H (2002) Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med 347:472–480

    Article  PubMed  CAS  Google Scholar 

  25. Van Oosterom AT, Judson I, Verweij J, Stroobants S, Donato di Paola E, Dimitrijevic S, Martens M, Webb A, Sciot R, Van Glabbeke M, Silberman S, Nielsen OS (2001) Safety and efficacy of imatinib (STI571) in metastatic gastrointestinal stromal tumours: a phase I study. Lancet 358:1421–1423

    Article  PubMed  Google Scholar 

  26. Mudan SS, Conlon KC, Woodruff JM, Lewis JJ, Brennan MF (2000) Salvage surgery for patients with recurrent gastrointestinal sarcoma: prognostic factors to guide patient selection. Cancer 88:66–74

    Article  PubMed  CAS  Google Scholar 

  27. Eilber FC, Rosen G, Forscher C, Nelson SD, Dorey F, Eilber FR (2000) Recurrent gastrointestinal stromal sarcomas. Surg Oncol 9:71–75

    Article  PubMed  CAS  Google Scholar 

  28. Nowain A, Bhakta H, Pais S, Kanel G, Verma S (2005) Gastrointestinal stromal tumors: clinical profile, pathogenesis, treatment strategies and prognosis. J Gastroenterol Hepatol 20:818–824

    Article  PubMed  Google Scholar 

  29. Efron J, Wexner SD (2001). Rectal cancer. In: Cameron JL (ed) Current surgical therapy, 7th edn. Elsevier Mosby, Philadelphia, pp 235–245

    Google Scholar 

  30. Vanel D, Albiter M, Shapeero L, Le Cesne A, Bonvalot S, Le Pechoux C, Terrier P, Petrow P, Caillet H, Dromain C (2005) Role of computed tomography in the follow-up of heptic and peritoneal metastases of GIST under imatinib mesylate treatment: a prospective study of 54 patients. Eur J Radiol 54:118–123

    Article  PubMed  Google Scholar 

  31. Van den Abbeele AD, Badawi RD (2002) Use of positron emission tomography in oncology and its potential role to assess response to imatinib mesylate therapy in gastrointestinal stromal tumors (GISTs). Eur J Cancer 38:S60–S65 (Suppl 5)

    PubMed  Google Scholar 

  32. Stroobants S, Goeminne J, Seegers M, Dimitrijevic S, Dupont P, Nuyts J, Martens M, van den Borne B, Cole P, Sciot R, Dumez H, Silberman S, Mortelmans L, van Oosterom A (2003) 18FDG-positron emission tomography for the early prediction of response in advanced soft tissue sarcoma treated with imatinib mesylate (Glivec). Eur J Cancer 39:2012–2020

    Article  PubMed  CAS  Google Scholar 

  33. Goerres GW, Stupp R, Barghouth G, Hany TF, Pestolazzi B, Dizendorf E, Schnyder P, Luthi F, von Schulthess GK, Leyvraz S (2005) The value of PET, CT and in-line PET/CT in patients with gastrointestinal stromal tumors: long-term outcome of treatment with imatinib mesylate. Eur J Nucl Med Mol Imaging 32:153–162

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, University of Chicago Hospitals, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA

    Marcovalerio Melis & Alessandro Fichera

  2. Department of Pathology, University of Chicago Hospitals, 5841 S. Maryland Avenue, Chicago, IL, 60637, USA

    Robert Anders & Peter Christiansen

  3. Department of Surgery, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd Unit 444, Houston, TX, 77030, USA

    Eugene A. Choi

Authors
  1. Marcovalerio Melis
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  2. Eugene A. Choi
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  3. Robert Anders
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  5. Alessandro Fichera
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Correspondence to Alessandro Fichera.

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Melis, M., Choi, E.A., Anders, R. et al. Synchronous colorectal adenocarcinoma and gastrointestinal stromal tumor (GIST). Int J Colorectal Dis 22, 109–114 (2007). https://doi.org/10.1007/s00384-006-0089-6

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  • DOI: https://doi.org/10.1007/s00384-006-0089-6

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