Báo cáo khoa học: Extra-gastrointestinal stromal tumor of the greater omentum: report of a case and review of the literature

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Extra-gastrointestinal stromal tumor of the greater omentum: report of a case and review of the literature
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Báo cáo khoa học: "Extra-gastrointestinal stromal tumor of the greater omentum: report of a case and review of the literature"World Journal of Surgical Oncology BioMed Central Open AccessReviewExtra-gastrointestinal stromal tumor of the greater omentum:report of a case and review of the literatureChristian Franzini1, Luciano Alessandri1, Irene Piscioli2, Salvatore Donato3,Rosario Faraci1, Luca Morelli4, Franca Del Nonno5 and Stefano Licci*5Address: 1Department of General Surgery, District Hospital of Guastalla (RE), Italy, 2Department of Radiology, Hospital of Budrio (BO), Italy,3Department of Radiology, Hospital of Bentivoglio (BO), Italy, 4Department of Pathology, S. Maria del Carmine Hospital, Rovereto (TN), Italyand 5Department of Pathology, National Institute for Infectious Diseases – L. Spallanzani IRCCS, Rome, ItalyEmail: Christian Franzini - chrisslrfra@libero.it; Luciano Alessandri - luciano.alessandri@ausl.re.it; Irene Piscioli - francesco.piscioli@apss.tn.it;Salvatore Donato - salvatore.donato@ausl.bo.it; Rosario Faraci - salvatore.donato@ausl.bo.it; Luca Morelli - luca.morelli@apss.tn.it; Franca DelNonno - delnonno@inmi.it; Stefano Licci* - licci@inmi.it* Corresponding authorPublished: 23 February 2008 Received: 6 December 2007 Accepted: 23 February 2008World Journal of Surgical Oncology 2008, 6:25 doi:10.1186/1477-7819-6-25This article is available from: http://www.wjso.com/content/6/1/25© 2008 Franzini et al; licensee BioMed Central Ltd.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0),which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: Gastrointestinal stromal tumors (GISTs) represent the majority of primary non- epithelial neoplasms of the digestive tract, most frequently expressing the KIT protein detected by the immunohistochemical staining for the CD117 antigen. Extra-gastrointestinal stromal tumors (EGISTs) are neoplasms with overlapping immunohistological features, occurring in the abdomen outside the gastrointestinal tract with no connection to the gastric or intestinal wall. Case presentation: We here report the clinical, macroscopic and immunohistological features of an EGIST arising in the greater omentum of a 74-year-old man, with a discussion on the clinical behavior and the prognostic factors of such lesions and a comparison with the gastrointestinal counterpart. Conclusion: The EGISTs in the greater omentum can grow slowly in the abdomen for a long time without clinical appearance. In most cases a preoperative diagnosis is not possible, and the patient undergoes a surgical operation for the generic diagnosis of abdominal mass. During the intervention it is important to achieve a complete removal of the mass and to examine every possible adhesion with the gastrointestinal wall. Yamamotos criteria based on the evaluation of the mitotic rate and the MIB-1 labelling index seems to be useful in predicting the risk for recurrence or metastasis. More studies are necessary to establish the prognostic factors related to localization and size of the EGIST and to evaluate the impact of the molecular characterization as an outcome parameter related to the molecular targeted therapy. In absence of these data, an accurate follow- up is recommended. They histologically, immunohistochemically and geneti-BackgroundStromal tumors represent the majority of primary non- cally differ from leiomyomas, leiomyosarcomas andepithelial neoplasms of the digestive tract and are collec- schwannomas. GISTs may be defined as intra-abdominaltively defined gastrointestinal stromal tumors (GISTs). mesenchymal tumors most frequently expressing the KIT Page 1 of 5 (page number not for citation purposes)World Journal of Surgical Oncology 2008, 6:25 http://www.wjso.com/content/6/1/25protein, having a gain-of-function mutation in the regula-tory juxtamembrane domain of the c-kit gene or an acti-vating mutation in another class III receptor tyrosinekinase gene, the PDGFRA gene, which encodes the plateletderived growth factor receptor-alpha receptor tyrosinekinase protein [1,2]. The KIT protein can be detected byimmunohistochemical assays for the CD117 antigen.GISTs are most commonly found in the stomach (40 to70%), small intestine (20 to 50%) and colorectum (5 to15%) [3-6]. Neoplasms with histology and immunohisto-chemistry similar to GISTs may occur outside the gastroin-testinal tract, for example in the soft tissue of theabdominal cavity (in particular omentum and mesentery)or in the retroperitoneum [7-9].These tumors must be defined as extr ...