Cutaneous and subcutaneous metastases of gastrointestinal stromal tumors: A series of 5 cases with molecular analysis

Wei Lien Wang, Jason L. Hornick, Raj Mallipeddi, Bettina G. Zelger, Joshua D. Rother, Dan Yang, Dina C. Lev, Jonathan C. Trent, Victor G. Prieto, Thomas Brenn, Eduardo Calonje, Alexander J.F. Lazar

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Gastrointestinal stromal tumors (GISTs) rarely metastasize to the skin. We describe 5 patients with GIST with subcutaneous and cutaneous metastases. The mean age at metastasis was 54 years (range 30-68 years) with a male predominance (4:1). Primary tumors occurred in the stomach (n = 3), small bowel (n = 1), and abdomen, not otherwise specified (n = 1). The average time from primary tumor resection to the resection of skin metastases was 59 months (range 11-155 months). The metastases occurred in the scalp (n = 2), cheek (n = 1), and abdomen (n = 2) with 3 patients presenting with solitary nodules and 2 patients with multiple nodules. The average size was 2 cm (range 0.6-4 cm). Histologically, 2 cases were spindled and 3 cases demonstrated mixed epithelioid and spindle cell morphology. All were confirmed to have CD117 reactivity. KIT genotyping was performed in 4 of 5 cases. Two cases harbored a mutation in exon 11, and the remaining 2 cases were wild type in exons 9, 11, 13, and 17. All 5 patients had multiple concurrent or subsequent abdominal and/or hepatic metastases. In 4 patients with an average follow-up of 32 months (range 6-75 months), after the resection of the metastases, 2 were alive with disease and 2 died of disease. Cutaneous metastases seem to be a late complication of GIST, but their presence does not necessarily herald a rapid demise of the patient.

Original languageEnglish (US)
Pages (from-to)297-300
Number of pages4
JournalAmerican Journal of Dermatopathology
Volume31
Issue number3
DOIs
StatePublished - May 2009

Keywords

  • Cutaneous
  • Gastrointestinal stromal tumor
  • GIST
  • Metastasis
  • Skin

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Dermatology
  • Medicine(all)

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    Wang, W. L., Hornick, J. L., Mallipeddi, R., Zelger, B. G., Rother, J. D., Yang, D., Lev, D. C., Trent, J. C., Prieto, V. G., Brenn, T., Calonje, E., & Lazar, A. J. F. (2009). Cutaneous and subcutaneous metastases of gastrointestinal stromal tumors: A series of 5 cases with molecular analysis. American Journal of Dermatopathology, 31(3), 297-300. https://doi.org/10.1097/DAD.0b013e31818acb1a