Collision of adenocarcinoma and gastrointestinal stromal tumour (GIST) in the stomach: report of a case
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BioMed Central
Open Access
Case report
Collision of adenocarcinoma and gastrointestinal stromal tumour (GIST) in the stomach: report of a case Iraklis E Katsoulis*1, Manuela Bossi1, Paul I Richman2 and Jeremy I Livingstone1 Address: 1Upper Gastrointestinal Surgery Unit, Watford General Hospital, Watford, UK and 2Pathology Department, Mount Vernon Cancer Centre, London, UK Email: Iraklis E Katsoulis* - [email protected]; Manuela Bossi - [email protected]; Paul I Richman - [email protected]; Jeremy I Livingstone - [email protected] * Corresponding author
Published: 12 January 2007 International Seminars in Surgical Oncology 2007, 4:2
doi:10.1186/1477-7800-4-2
Received: 14 December 2006 Accepted: 12 January 2007
This article is available from: http://www.issoonline.com/content/4/1/2 © 2007 Katsoulis 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 A 78-year-old woman was diagnosed with a proximal gastric adenocarcinoma and underwent an elective D2 total gastrectomy with splenectomy. Subsequent histopathology revealed the presence of another tumour at the gastric antrum. This was a small benign gastrointestinal stromal tumour (GIST) mixed with gastric adenocarcinoma cells similar to those of the main gastric tumour i.e. a collision tumour. The literature has only few previous reports of this very rare association. It is not known whether this synchronicity is incidental or there is a causative factor inducing the development of tumours of different histotypes in the same organ. Pathologists, oncologists and surgeons should be aware of this interesting condition.
Background Adenocarcinoma is the most common histological type of gastric tumour. It may coexist with another synchronous tumour of different histological type in a different part of the stomach. Gastric adenocarcinoma may coexist most commonly with lymphoma and less commonly with carcinoid and gastrointestinal stromal tumour (GIST). Rarely, cells of different histological types may intermix and form a collision tumour in the stomach. We present here the very rare combination of a synchronous proximal gastric adenocarcinoma and a distal gastric collision tumour consisting of GIST and adenocarcinoma cells similar to those of the main gastric tumour.
Case Presentation A 78-year-old woman presented with a 6-month history of dyspeptic symptoms, epigastric pain and weight loss.
Gastroscopy showed mucosal nodularity and ulceration at the proximal gastric body with an "hour glass" deformity, an appearance suggestive of malignancy. Multiple mucosal biopsies were obtained and histopathology revealed a poorly differentiated adenocarcinoma and chronic gastritis. Computed tomography of the abdomen showed diffuse thickening of the gastric wall and a few enlarged lymph nodes
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