Case Report

Coexistence of Hepatocellular Carcinoma (HCC) and c-Kit Negative Gastrointestinal Stromal Tumor (GIST): A Case Report

Authors: Evangelos Felekouras, MD, Petrou Athanasios, MD, Stefani Vgenopoulou, MD, Ioannis Papaconstantinou, MD, Evangelos Prassas, MD, Athanasios Giannopoulos, MD, John Griniatsos, MD

Abstract

A past history of sporadic solid cancers is disclosed in 10% of gastrointestinal stromal tumor (GIST) patients. Simultaneous occurrence with other malignancies is encountered in 14 to 16%, but the synchronous occurrence of GIST and hepatocellular carcinoma (HCC) has been reported only once in the English literature. An 81-year-old male patient is presented with a preoperatively known HCC, in whom a synchronous small nodular omental GIST adjacent to the lesser curvature of the stomach was incidentally discovered. When a GIST is encountered, a thorough intraoperative investigation of the abdominal cavity currently remains the only reliable method for detection of a possible coexisting malignancy.


Key Points


* In cases of known hepatocellular carcinoma (HCC), any pre- or intraoperative effort to rule out extrahepatic spread of the disease should be made, since extrahepatic spread of the disease correlates to a documented unfavorable prognosis.


* The simple disclosure of an abdominal mass during the follow-up period in patients with a history of solid cancers cannot accurately define the exact nature of it.


* The patient we present may have the second reported case of coexisting gastrointestinal stromal tumor (GIST) and HCC, but is the first in whom the stromal tumor was histologically defined as c-Kit negative, but strongly platelet-derived growth factor receptor-alpha (PDGFR-A) positive.

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