Esophageal Gastrointestinal Stromal Tumor with Rare Intracranial Metastasis
Introduction. Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors and constitute the largest group of nonepithelial digestive neoplasms. However, they do not represent more than 1% of primary digestive tumors. They commonly metastasize to the liver and peritoneum, but brain metastases are...
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| Format: | Article |
| Language: | English |
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Wiley
2020-01-01
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| Series: | Case Reports in Gastrointestinal Medicine |
| Online Access: | http://dx.doi.org/10.1155/2020/8842006 |
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| author | José Carvalho Margarida Teixeira Francisco Teixeira Silva Alexandra Esteves Carlos Ribeiro Diana Guerra |
| author_facet | José Carvalho Margarida Teixeira Francisco Teixeira Silva Alexandra Esteves Carlos Ribeiro Diana Guerra |
| author_sort | José Carvalho |
| collection | DOAJ |
| description | Introduction. Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors and constitute the largest group of nonepithelial digestive neoplasms. However, they do not represent more than 1% of primary digestive tumors. They commonly metastasize to the liver and peritoneum, but brain metastases are extremely rare. Clinical Case. A 76-year-old woman with a diagnosis of esophageal GIST with liver and lung metastases for 13 years, medicated with imatinib, is presented. She was brought to the emergency department after falling and due to changes in behavior and vertigo with 24 hours of evolution. On physical examination, she presented changes in behavior, dysarthria, dysmetria on the right, gait imbalance, and no motor or sensory deficits. On brain computed tomography and posteriorly on magnetic resonance, 2 lesions were observed, left frontal and right cerebellar, compatible with metastatic lesions. After contribution of neurosurgery, histology was obtained that confirmed the lesions were GIST metastases. Imatinib was maintained, and whole brain radiotherapy was performed. After 6 months, she died. Discussion. The rarity of GIST brain metastases is noteworthy, and because of that, there is not enough experience to be certain of the best treatment. Our patient lived for 13 years with excellent disease control with imatinib, but the fact that it does not cross the blood-brain barrier makes it not useful in preventing or treating brain lesions. New tyrosine kinase inhibitors that may cross the blood-brain barrier could be the answer to these cases. |
| format | Article |
| id | doaj-art-8e6fd888013d473d91b1a6673a9e5813 |
| institution | Kabale University |
| issn | 2090-6528 2090-6536 |
| language | English |
| publishDate | 2020-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Gastrointestinal Medicine |
| spelling | doaj-art-8e6fd888013d473d91b1a6673a9e58132025-02-03T06:05:39ZengWileyCase Reports in Gastrointestinal Medicine2090-65282090-65362020-01-01202010.1155/2020/88420068842006Esophageal Gastrointestinal Stromal Tumor with Rare Intracranial MetastasisJosé Carvalho0Margarida Teixeira1Francisco Teixeira Silva2Alexandra Esteves3Carlos Ribeiro4Diana Guerra5Serviço de Medicina Interna, ULSAM—Hospital de Santa Luzia, Viana Do Castelo, PortugalServiço de Anatomia Patológica, Hospital de Braga, Braga, PortugalServiço de Medicina Interna, ULSAM—Hospital de Santa Luzia, Viana Do Castelo, PortugalServiço de Medicina Interna, ULSAM—Hospital de Santa Luzia, Viana Do Castelo, PortugalServiço de Medicina Interna, ULSAM—Hospital de Santa Luzia, Viana Do Castelo, PortugalServiço de Medicina Interna, ULSAM—Hospital de Santa Luzia, Viana Do Castelo, PortugalIntroduction. Gastrointestinal stromal tumors (GISTs) are mesenchymal tumors and constitute the largest group of nonepithelial digestive neoplasms. However, they do not represent more than 1% of primary digestive tumors. They commonly metastasize to the liver and peritoneum, but brain metastases are extremely rare. Clinical Case. A 76-year-old woman with a diagnosis of esophageal GIST with liver and lung metastases for 13 years, medicated with imatinib, is presented. She was brought to the emergency department after falling and due to changes in behavior and vertigo with 24 hours of evolution. On physical examination, she presented changes in behavior, dysarthria, dysmetria on the right, gait imbalance, and no motor or sensory deficits. On brain computed tomography and posteriorly on magnetic resonance, 2 lesions were observed, left frontal and right cerebellar, compatible with metastatic lesions. After contribution of neurosurgery, histology was obtained that confirmed the lesions were GIST metastases. Imatinib was maintained, and whole brain radiotherapy was performed. After 6 months, she died. Discussion. The rarity of GIST brain metastases is noteworthy, and because of that, there is not enough experience to be certain of the best treatment. Our patient lived for 13 years with excellent disease control with imatinib, but the fact that it does not cross the blood-brain barrier makes it not useful in preventing or treating brain lesions. New tyrosine kinase inhibitors that may cross the blood-brain barrier could be the answer to these cases.http://dx.doi.org/10.1155/2020/8842006 |
| spellingShingle | José Carvalho Margarida Teixeira Francisco Teixeira Silva Alexandra Esteves Carlos Ribeiro Diana Guerra Esophageal Gastrointestinal Stromal Tumor with Rare Intracranial Metastasis Case Reports in Gastrointestinal Medicine |
| title | Esophageal Gastrointestinal Stromal Tumor with Rare Intracranial Metastasis |
| title_full | Esophageal Gastrointestinal Stromal Tumor with Rare Intracranial Metastasis |
| title_fullStr | Esophageal Gastrointestinal Stromal Tumor with Rare Intracranial Metastasis |
| title_full_unstemmed | Esophageal Gastrointestinal Stromal Tumor with Rare Intracranial Metastasis |
| title_short | Esophageal Gastrointestinal Stromal Tumor with Rare Intracranial Metastasis |
| title_sort | esophageal gastrointestinal stromal tumor with rare intracranial metastasis |
| url | http://dx.doi.org/10.1155/2020/8842006 |
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