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      • Record: found
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      Gastrointestinal stromal tumor metastasis at the site of a totally implantable venous access port insertion: A rare case report

      case-report

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          Abstract

          BACKGROUND

          The totally implantable venous access port (TIVAP) is an important device in patients for injecting blood products, parenteral nutrition or antineoplastic chemotherapy. Metastatic spread at the site of the insertion of a TIVAP is extremely rare.

          CASE SUMMARY

          We report the case of 33-year-old male with advanced gastrointestinal stromal tumor (GIST) who underwent radical tumor resection after neoadjuvant imatinib therapy. However, a solitary GIST metastasis at the site of a TIVAP insertion developed during adjuvant imatinib treatment. Mutational analysis showed secondary mutation in KIT exon 13 (V564A), which is resistant to imatinib treatment. To our knowledge, this is the first case report of a patient with advanced GIST developing GIST metastasis at the site of a TIVAP insertion.

          CONCLUSION

          This case highlights that when a patient with advanced, high metastatic GIST requires TIVAP insertion, we should realize that there is a risk of developing tumor metastasis at the site of a TIVAP insertion.

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          Most cited references13

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          Preventing complications of central venous catheterization.

          David C McGee, Michael K Gould (2003)
          Article 0 comments Cited 458 times – based on 0 reviews     Review now
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            Diagnosis of gastrointestinal stromal tumors: A consensus approach.

            D B Longley, Gordon J. Berman, Christopher Fletcher … (2002)
            As a result of major recent advances in understanding the biology of gastrointestinal stromal tumors (GISTs), specifically recognition of the central role of activating KIT mutations and associated KIT protein expression in these lesions, and the development of novel and effective therapy for GISTs using the receptor tyrosine kinase inhibitor STI-571, these tumors have become the focus of considerable attention by pathologists, clinicians, and patients. Stromal/mesenchymal tumors of the gastrointestinal tract have long been a source of confusion and controversy with regard to classification, line(s) of differentiation, and prognostication. Characterization of the KIT pathway and its phenotypic implications has helped to resolve some but not all of these issues. Given the now critical role of accurate and reproducible pathologic diagnosis in ensuring appropriate treatment for patients with GIST, the National Institutes of Health convened a GIST workshop in April 2001 with the goal of developing a consensus approach to diagnosis and morphologic prognostication. Key elements of the consensus, as described herein, are the defining role of KIT immunopositivity in diagnosis and a proposed scheme for estimating metastatic risk in these lesions, based on tumor size and mitotic count, recognizing that it is probably unwise to use the definitive term "benign" for any GIST, at least at the present time. Copyright 2002, Elsevier Science (USA). All rights reserved.
            Article 0 comments Cited 375 times – based on 0 reviews     Review now
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              Gastrointestinal stromal tumour.

              Michael Heinrich, David Rubin, Christopher L Corless (2007)
              Gastrointestinal stromal tumours are the most common mesenchymal neoplasm of the gastrointestinal tract and are highly resistant to conventional chemotherapy and radiotherapy. Such tumours usually have activating mutations in either KIT (75-80%) or PDGFRA (5-10%), two closely related receptor tyrosine kinases. These mutations lead to ligand-independent activation and signal transduction mediated by constitutively activated KIT or PDGFRA. Targeting these activated proteins with imatinib mesylate, a small-molecule kinase inhibitor, has proven useful in the treatment of recurrent or metastatic gastrointestinal stromal tumours and is now being tested as an adjuvant or neoadjuvant. However, resistance to imatinib is a growing problem and other targeted therapeutics such as sunitinib are available. The important interplay between the molecular genetics of gastrontestinal stromal tumour and responses to targeted therapeutics serves as a model for the study of targeted therapies in other solid tumours.
              Article 0 comments Cited 77 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Xiao-Nan Yin:
                Comment :

                Yin XN

                Yuan Yin:
                Comment :

                Yin Y

                Jiang Wang:
                Comment :

                Wang J

                Chao-Yong Shen:
                Comment :

                Shen CY

                Xin Chen:
                Comment :

                Chen X

                Zhou Zhao:
                Comment :

                Zhao Z

                Zhao-Lun Cai:
                Comment :

                Cai ZL

                Bo Zhang:
                Comment :

                Zhang B

                Journal
                Journal ID (nlm-ta): World J Clin Cases
                Journal ID (publisher-id): WJCC
                Title: World Journal of Clinical Cases
                Publisher: Baishideng Publishing Group Inc
                ISSN (Electronic): 2307-8960
                Publication date (Print): 26 October 2020
                Publication date (Electronic): 26 October 2020
                Volume: 8
                Issue: 20
                Pages: 5007-5012
                Affiliations
                Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
                Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
                Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
                Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
                Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
                Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
                Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
                Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China. hxwcwk@ 123456126.com
                Author notes

                Author contributions: Zhang B carried out concept design; Yin XN and Yin Y carried out data analysis and wrote the manuscript; Wang J and Shen CY carried out data acquisition and data analysis; Chen X and Zhao Z carried out data acquisition and the literature search; Zhao Z and Cai ZL edited and revised the manuscript; all the authors have read and approved the final manuscript.

                Supported by the National Natural Science Foundation of China, No. 81572931; and 1.3.5 Project for Disciplines of Excellence, West China Hospital, Sichuan University, No. ZYJC18034.

                Corresponding author: Bo Zhang, MD, PhD, Professor, Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Lane, Chengdu 610041, Sichuan Province, China. hxwcwk@ 123456126.com

                Article
                Other ID: jWJCC.v8.i20.pg5007
                DOI: 10.12998/wjcc.v8.i20.5007
                PMC ID: 7642564
                PubMed ID: 33195674
                SO-VID: 191e2d7e-aa1c-4504-b7c9-fa71ab5cdf07
                Copyright © ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
                License:

                This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.

                History
                Date received : 21 June 2020
                Date revision received : 28 July 2020
                Date accepted : 2 September 2020
                Categories
                Subject: Case Report

                Keywords: tumor metastasis,gastrointestinal stromal tumor,totally implantable venous access port,targeted therapy,mutational analysis,computed tomography,case report
                Data availability:
                Keywords: tumor metastasis, gastrointestinal stromal tumor, totally implantable venous access port, targeted therapy, mutational analysis, computed tomography, case report

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