J Gastric Cancer.  2015 Dec;15(4):290-294. 10.5230/jgc.2015.15.4.290.

C-Kit-Negative Gastrointestinal Stromal Tumor in the Stomach

• Seo HS
• Hyeon JY
• Shin OR
• Lee HH

• KMID: 2391565
• DOI: http://doi.org/10.5230/jgc.2015.15.4.290

Abstract

C-kit-negative gastrointestinal stromal tumors (GISTs) are uncommon, and there have been few reports about the diagnosis and treatment of c-kit-negative GISTs in the stomach. We report the case of a patient who was diagnosed with a huge and atypical GIST in the stomach. The GIST was completely resected and finally diagnosed as c-kit-negative GIST based on immunohistochemical staining of tumor cells, which were negative for CD117 and CD34 and positive for Discovered on GIST-1 (DOG1). C-kit-negative GISTs could be treated by complete resection and/or imatinib, which is the same treatment for c-kit-positive GISTs.

Keyword

C-kit protein; DOG1 protein; Gastrointestinal stromal tumors

MeSH Terms

Diagnosis
Gastrointestinal Stromal Tumors*
Humans
Proto-Oncogene Proteins c-kit
Stomach*
Imatinib Mesylate
Proto-Oncogene Proteins c-kit

Figure

• 

  Fig. 1 Computed tomography shows an 18.0×15.0 cm irregular enhancing soft tissue mass (arrows) with exophytic growth on the anterior wall of the stomach.

• 

  Fig. 2 The resected specimen reveals a multi-lobulated, yellow, soft, and fleshy mass with focal involvement of adjacent adipose tissue.

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  Fig. 3 Microscopic features. (A) At lower magnification, a hypercellular tumor lesion with diffuse sheet-like growth pattern is identified (H&E, ×100). (B) There are focal areas of hyalinized stroma with slit-like vessels and some capillaries (H&E, ×100). (C) At higher magnification, epithelioid tumor cells with prominent cytoplasmic vacuoles and moderately pleomorphic nuclei are identified (H&E, ×400). (D) Frequent mitotic figures (arrows) are observed (H&E, ×400).

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  Fig. 4 Immunohistochemical staining (×200). Tumor cells are negative for CD117 (A) and CD34 (B). (C) The membrane and cytoplasm of tumor cells are stained for DOG1.

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