Voluminous gastric fibrosarcoma in a 75-year-old patient
© Carcano et al; licensee BioMed Central Ltd. 2009
Published: 1 April 2009
Gastrointestinal stromal tumors are mesenchymal neoplasms of the gastrointestinal tract, arising from the muscular layer. Revent immunohistochemical studies have shown that up to 94% of GISTs express 117, and 60–70% of GISTs stain for CD 34. GISTs account for 1% of all malignant tumors of gastrointestinal tract; they arise from stomach in the 40–60% of cases whereas they account only for 3% of gastric malignant neoplasms. GISTs can occur at any age but onset most commonly in the sixth and the seventh decades of life.
We report the case of a 69-year-old male patient admitted to our surgical department with weakness, progressive abdominal straining and weight loss of 5 kg in 6 months.
The final histological findings confirmed the diagnosis of malignant neoplasm pT2 with fused cells compatible with fibrosarcoma poorly differentiated. The immunohistochemistry of the fused cell showed no positivity for CD 34, actin, ema andcytokeratins. The proliferative index was 7 mitoses per 10 HPF.
As reported in literature the GIST described in our case presented aspecific clinical finding and a not clear origin at CT scanning. In our case the high mitotic index (>5 mitoses per 10 HPF) and the tumor size greater than 5 cm manifest an aggressive biological behavior associated with a poor prognosis. In this case anyway the tumor doesn't result positive to CD 117 or CD 34 though presenting fused cells with mesenchimal phenotype.
This article is published under license to BioMed Central Ltd.