15
views
0
recommends
+1 Recommend
2 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Extragastrointestinal Stromal Tumor Masquerading as a Leiomyoma in a Case of Postmenopausal Bleeding: A Rare Case Report!

      case-report

      Read this article at

      ScienceOpenPublisher
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          ABSTRACT

          Introduction

          A rare case report of bladder extragastrointestinal stromal tumor is being reported, which presented as a leiomyoma on imaging studies in a patient with recurrent postmenopausal bleeding. This is the fifth case being reported in the literature.

          Case description

          A 54-year-old woman reported to outpatient department (OPD) of a tertiary level government hospital with recurrent postmenopausal bleeding. The general physical examination of the patient was normal and vital signs were stable. On abdominal examination, a firm mass was felt arising from the pelvis corresponding to a 16-week size uterus. The ultrasound (USG) report mentioned a 12 × 12.7 × 10.8 cm well-defined heterogeneously hypoechoic lesion with areas of central necrosis arising from the anterior wall of the uterus. Contrast-enhanced computerized tomography (CECT) was reported as a subserosal degenerative fibroid with bilateral normal ovaries. The patient was investigated and planned for hysterectomy in view of recurrent postmenopausal bleeding with a large fibroid. Intraoperatively, the uterus, bilateral tubes, and ovaries were found to be normal. A 16 × 14 cm yellowish-firm mass with multiple areas of cystic degeneration and necrosis was seen on the right side, which appeared to be arising from the bladder. A hysterectomy with bilateral salpingo-oophorectomy was done. A tumor was seen arising from the posterior wall of the supratrigonal region of the bladder. A complete resection of the tumor was done and the bladder was repaired in two layers. Metastasis and any other primary foci were ruled out. On immunohistochemistry (IHC), the tumor was positive for CD117, desmin, and DOG1. The final impression was a gastrointestinal stromal tumor of the urinary bladder.

          Conclusion

          Extragastrointestinal stromal tumor of the urinary bladder is a very rare tumor, which is difficult to diagnose preoperatively. Immunohistochemistry, is required to diagnose.

          How to cite this article

          Malik R, Tandon NP, Chopra N, et al. Extragastrointestinal Stromal Tumor Masquerading as a Leiomyoma in a Case of Postmenopausal Bleeding: A Rare Case Report! J South Asian Feder Obst Gynae 2023;15(3):341–343.

          Related collections

          Most cited references4

          • Record: found
          • Abstract: found
          • Article: not found

          GEIS guidelines for gastrointestinal sarcomas (GIST).

          Gastrointestinal stromal sarcomas (GISTs) are the most common mesenchymal tumours originating in the digestive tract. They have a characteristic morphology, are generally positive for CD117 (c-kit) and are primarily caused by activating mutations in the KIT or PDGFRA genes(1). On rare occasions, they occur in extravisceral locations such as the omentum, mesentery, pelvis and retroperitoneum. GISTs have become a model of multidisciplinary work in oncology: the participation of several specialties (oncologists, pathologists, surgeons, molecular biologists, radiologists…) has forested advances in the understanding of this tumour and the consolidation of a targeted therapy, imatinib, as the first effective molecular treatment in solid tumours. Following its introduction, median survival of patients with advanced or metastatic GIST increased from 18 to more than 60months. Sunitinib and Regorafenib are two targeted agents with worldwide approval for second- and third-line treatment, respectively, in metastatic GIST.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Recent advances in the treatment of gastrointestinal stromal tumors.

            Constitutively activating mutations in the KIT and platelet-derived growth factor receptor α (PDGFRA) RTKs play a crucial role in the biology of gastrointestinal stromal tumors (GISTs), and this disease has served as an effective model for targeting gain-of-function kinase mutations in cancer. Imatinib has entered the clinical arena in the last decade and substantially improved the outcome in these formerly untreatable cancers. However, most advanced GISTs responding to imatinib progress within 2-3 years due to heterogeneous subclones harboring a range of imatinib-resistant secondary KIT mutations. Sunitinib, and more recently, regorafenib, have obtained US Food and Drug Administration approval for the treatment of GISTs after imatinib failure, and thus expanded the treatment options in resistant disease. Within this framework, we present an evaluation of current GIST management, emphasizing the most recent advances in the field together with a discussion on future steps to be taken in refractory disease.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Rare gastrointestinal stromal tumors (GIST): omentum and retroperitoneum.

              Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms that arise in the gastrointestinal tract and rarely elsewhere in the abdomen. GISTs that develop outside the digestive tract are called extra-GISTs (EGISTs). The incidence of EGISTs is reported to be approximately 10% of all GISTs, and the median age is younger than that of conventional GISTs. EGISTs have similar histology and immunohistochemical features as conventional GISTs, with the majority of them in the omentum and mesentery. Most GISTs harbor a kinase-activating mutation in either KIT or PDGFRA. For EGISTs, the incidence of this type of mutation is 40-50%, which is somewhat lower than for conventional GISTs. EGISTs may have a worse prognosis compared with conventional GISTs with high mitotic indices, large size, and distant metastasis including lymph node involvement. In large abdominal tumors, the visceral origin is almost impossible to discern.
                Bookmark

                Author and article information

                Contributors
                Journal
                JSAFOG
                Journal of South Asian Federation of Obstetrics and Gynaecology
                JSAFOG
                Jaypee Brothers Medical Publishers
                0974-8938
                0975-1920
                May-June 2023
                : 15
                : 3
                : 341-343
                Affiliations
                [1 ]Department of Obstetrics and Gynaecology, PGIMER, RML Hospital, New Delhi, India
                [2 ]Department of Obstetrics and Gynaecology, ABVIMS, New Delhi, India
                [3 ]Department of Obstetrics and Gynaecology, Government Medical College, Patiala, Punjab, India
                [4 ]Department of Urology, ABVIMS, New Delhi, India
                [5 ]Department of Pathology, Dr Ram Manohar Lohia Hospital, New Delhi, India
                Author notes
                Renuka Malik, Department of Obstetrics and Gynaecology, PGIMER, RML Hospital, New Delhi, India, Phone: +91 9871867700, e-mail: renucam@ 123456yahoo.co.in
                Article
                10.5005/jp-journals-10006-2234
                335b7f38-7413-4fc4-8d58-60aa46a088e2
                Copyright © 2023; The Author(s).

                © The Author(s). 2023 Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and non-commercial reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 16 March 2023
                : 06 April 2023
                : 31 July 2023
                Categories
                CASE REPORT
                Custom metadata
                jsafog-15-341.pdf

                Obstetrics & Gynecology
                Extragastrointestinal tumor,Urinary bladder,Postmenopausal bleeding,Leiomyoma,Immunohistochemistry

                Comments

                Comment on this article