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Virchows Archiv

, Volume 471, Issue 1, pp 77–90 | Cite as

Clinical and pathological characteristics of gastrointestinal stromal tumor (GIST) metastatic to bone

  • Kemal Kosemehmetoglu
  • Gulsah Kaygusuz
  • Karen Fritchie
  • Ovgu Aydin
  • Ozlem Yapicier
  • Oznur Coskun
  • Ersin Karatayli
  • Senay Boyacigil
  • Gulnur Guler
  • Sergulen Dervisoglu
  • Isinsu Kuzu
Original Article

Abstract

Our aim in this study was to describe the clinical, morphological, and molecular profile of gastrointestinal stromal tumor (GIST) metastatic to bone. We analyzed the morphological, phenotypic, and molecular characteristics of seven cases, and in addition reviewed 17 cases from literature. Sequence analysis of KIT and PDGFRA genes was possible for six cases. For the GIST cases with bone metastasis, the most common primaries were small intestine (29%), stomach (25%), and rectum (21%). Sites of bone metastases were vertebrae (11), pelvis (8), femur (8), ribs (6), humerus (5), skull (3), scapula (1), and mandible (1). The size ranged from 1.5 to 13 cm (median, 3.8 cm). Bone metastases without involvement of any other organ were seen in 17% of the cases and were solitary in 14 (58%). Adjacent soft tissue involvement was present in nearly half of the patients. Bone metastasis was either manifest at the time of diagnosis (28%) or occurred after a mean period of 4.7 years (3 months–20 years). Morphologically, neoplastic cells were spindle in 67%, epithelioid in 13%, and mixed epithelioid and spindle in 20%. CD117, DOG1, and CD34 were positive in 88, 86, and 85% of the cases, respectively. KIT Exon 11 mutations were the most frequent gene alteration (78%), followed by KIT Exon 13 mutations. Of 17 of the cases with available follow-up information, 7 (41%) patients developed bone metastasis under imatinib therapy. Five patients (29%) died of disease within a mean of 17 months. Bone metastases from GIST are usually found in patients with advanced disease and typically present as lytic masses with occasional soft tissue involvement. We could not identify any KIT or PDGFRA alterations predisposing to bone metastasis.

Keywords

Gastrointestinal stromal tumor Bone metastasis Mutation DOG1 KIT PDGFRA 

Notes

Acknowledgements

The molecular studies and DOG1 staining were performed in Ankara University, Department of Pathology, and supported by an institutional contribution of TUBITAK (project no.: 209S109).

This study presented as poster at the USCAP Meeting, Baltimore, USA, 2013.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

428_2017_2138_MOESM1_ESM.docx (23 kb)
ESM 1 (DOCX 22 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Kemal Kosemehmetoglu
    • 1
  • Gulsah Kaygusuz
    • 2
  • Karen Fritchie
    • 3
  • Ovgu Aydin
    • 4
  • Ozlem Yapicier
    • 5
  • Oznur Coskun
    • 2
  • Ersin Karatayli
    • 6
  • Senay Boyacigil
    • 2
  • Gulnur Guler
    • 7
  • Sergulen Dervisoglu
    • 4
  • Isinsu Kuzu
    • 2
  1. 1.Department of PathologyHacettepe University School of MedicineAnkaraTurkey
  2. 2.Department of PathologyAnkara University School of MedicineAnkaraTurkey
  3. 3.Department of Laboratory Medicine and PathologyMayo ClinicRochesterUSA
  4. 4.Department of PathologyIstanbul University Cerrahpasa School of MedicineIstanbulTurkey
  5. 5.Department of PathologyAcıbadem University School of MedicineIstanbulTurkey
  6. 6.Hepatology InstituteAnkara UniversityAnkaraTurkey
  7. 7.AnkaraTurkey

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