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

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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.

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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.

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  1. Kemal Kosemehmetoglu and Gulsah Kaygusuz equally contributed to the study.

Authors and Affiliations

  1. Department of Pathology, Hacettepe University School of Medicine, Ankara, Turkey

    Kemal Kosemehmetoglu

  2. Department of Pathology, Ankara University School of Medicine, Ankara, Turkey

    Gulsah Kaygusuz, Oznur Coskun, Senay Boyacigil & Isinsu Kuzu

  3. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA

    Karen Fritchie

  4. Department of Pathology, Istanbul University Cerrahpasa School of Medicine, Istanbul, Turkey

    Ovgu Aydin & Sergulen Dervisoglu

  5. Department of Pathology, Acıbadem University School of Medicine, Istanbul, Turkey

    Ozlem Yapicier

  6. Hepatology Institute, Ankara University, Ankara, Turkey

    Ersin Karatayli

  7. Ankara, Turkey

    Gulnur Guler

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Kosemehmetoglu, K., Kaygusuz, G., Fritchie, K. et al. Clinical and pathological characteristics of gastrointestinal stromal tumor (GIST) metastatic to bone. Virchows Arch 471, 77–90 (2017). https://doi.org/10.1007/s00428-017-2138-7

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