Korean J Hematol.  2010 Mar;45(1):66-69. 10.5045/kjh.2010.45.1.66.

Synchronous development of KIT positive acute myeloid leukemia in a patient with gastrointestinal stromal tumor

• Joo YB
• Choi SH
• Kim SK
• Shim B
• Kim MS
• Kim YJ

• KMID: 2252092
• DOI: http://doi.org/10.5045/kjh.2010.45.1.66

Abstract

We report a case of synchronous occurrence of KIT-positive acute myeloid leukemia (AML) and gastrointestinal stromal tumor (GIST). A 63-year-old woman was hospitalized for dizziness, and abdominal computed tomography revealed an exophytic gastric mass and hepatic metastasis. The patient was diagnosed with GIST and was administered imatinib (400 mg/day) for the metastatic unresectable tumor. After 2 weeks of imatinib treatment, the patient developed pancytopenia, which persisted even after the drug was discontinued, thereby necessitating bone marrow biopsy. Biopsy examination indicated AML, and karyotyping revealed a complex karyotype. We did not observe point mutations at residues D816 and N822 of KIT. Therefore, the patient received standard induction chemotherapy, but on the 18th day after completion of chemotherapy, she died of septic shock and multi-organ failure. Since KIT plays an important role in both GIST and AML, we consider that both these malignancies may have been associated with each other.

Keyword

KIT; Acute myeloid leukemia; Gastrointestinal stromal tumor

MeSH Terms

Benzamides
Biopsy
Bone Marrow
Dizziness
Female
Gastrointestinal Stromal Tumors
Humans
Induction Chemotherapy
Karyotype
Karyotyping
Leukemia, Myeloid, Acute
Middle Aged
Neoplasm Metastasis
Pancytopenia
Piperazines
Point Mutation
Pyrimidines
Shock, Septic
Imatinib Mesylate
Benzamides
Piperazines
Pyrimidines

Figure

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  Fig. 1 Esophagogastroenteroscopy shows an ulcerofungating mass lesion in the posterior wall of the gastric fundus. The mass is covered with normal mucosa-like submucosal tumor, but it has a large ulceration at the centre.

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  Fig. 2 Abdominal computed tomography shows an 8×7.3 cm exophytic gastric mass in the posterior wall of the gastric body containing a large area of cavitation and variable hepatic metastasis.

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  Fig. 3 (A) Poorly differentiated malignant-cell infiltrates with epithelioid features in the myxoid stroma. (B) Immunohistochemical staining of cytokeratins (CK MNF116) is negative. (C) Immunohistochemical staining of KIT is positive. (D) The uniform population of primitive myeloblasts is indicative of acute myeloid leukemia.

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