Abstract
A 71-year-old man who had undergone surgical resection of esophageal gastrointestinal stromal tumors (GISTs) through a right posterolateral thoracotomy 8 years earlier was referred for treatment of an anterior mediastinal mass discovered on a follow-up chest radiograph in October 2007. Computed tomography findings revealed a tumor, 82 × 49 mm, with calcification, in the anterior mediastinum. When we radically resected the tumor via a median sternectomy, we found that it was actually located in the pleural cavity, and there was a small nodule near the main tumor on other pleura. Microscopically, the tumor was comprised of uniform spindle cells with fibrillary eosinophilic cytoplasm. In addition, immunostaining showed that the tumor was positive for CD117 (c-kit). The diagnosis was pleural dissemination of esophageal GISTs 8 years after primary surgery, making this the first report of pleural dissemination of esophageal GISTs after such a prolonged postsurgical interval.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Mazur MT, Clark HB. Gastric stromal tumors: reappraisal of histogenesis. Am J Surg Pathol 1983;7:507–519.
Miettinen M, Lasota J. Gastrointestinal stromal tumors: definition, clinical, histological, immunohistochemical, and molecular genetic features and differential diagnosis. Virchows Arch 2001;438:1–12.
Lee JR, Joshi V, Griffin JW, Lasota J, Miettinen M. Gastrointestinal autonomic nerve tumor: immunohistochemical and molecular identity with gastrointestinal stromal tumor. Am J Surg Pathol 2001;25:979–987.
Lee JR, Anstadt MP, Khwaja S, Green LK. Gastrointestinal stromal tumor of the posterior mediastinum. Eur J Cardiothorac Surg 2002;22:1014–1016.
Tran T, Davila JA, El-Serag HB. The epidemiology of malignant gastrointestinal stromal tumors: an analysis of 1458 cases from 1992 to 2000. AmJ Gastroenterol 2005;100:162–168.
Van Ostcrom AT, Judson I, Vcrwcij J, Stroobants S, Donato di Paola E, Dimitrijevic S, et al. Safety and efficiency of imatinib in metastatic gastrointestinal stromal tumors: a phase I study. Lancet 2001;358:1421–1423.
Demetri GD, von Mehren M, Blanke CD, Van den Abbeele AD, Eisenberg B, Roberts PJ, et al. Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med 2002;347:472–480.
Demetri GD, Benjamin RS, Blanke CD, Blay JY, Casali P, Choi H, et al. NCCN Task Force report: optimal management of patients with gastrointestinal stromal tumor (GIST)-expansion and update of NCCN clinical practice guidelines. J Natl Compr Canc Netw 2004;2(suppl 1).
Dematteo RP, Ballman KV, Antonescu CR, Maki RG, Pisters PW, Demetri GD, et al. Adjuvant imatinib mesylate after resection of localised, primary gastrointestinal stromal tumour: a randomised, double-blind, placebo-controlled trial. Lancet 2009;373:1097–1104.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Imai, K., Saito, H., Minamiya, Y. et al. Pleural dissemination of esophageal gastrointestinal stromal tumors after an eight-year interval following the primary surgery. Gen Thorac Cardiovasc Surg 58, 302–305 (2010). https://doi.org/10.1007/s11748-009-0554-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11748-009-0554-6