GIST apendicular
DOI:
https://doi.org/10.30944/20117582.314Palabras clave:
apéndice, apendicitis, tumores del estroma gastrointestinal, diagnóstico diferencial, apendicectomíaResumen
El tumor del estroma gastrointestinal (Gastrointestinal Stromal Tumor, GIST), localizado en el apéndice, constituye una entidad poco frecuente. Su cuadro clínico e imaginológico es indistinguible de una apendicitis aguda, por lo que su diagnóstico definitivo está dado por el estudio histopatológico e inmunohistoquímico. El tratamiento estándar es la apendicectomía. El propósito de este artículo es la presentación de un caso clínico y la revisión de la literatura.
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Referencias bibliográficas
1. Nishida T, Hirota S. Biological and clinical review of stromal tumors in the gastrointestinal tract. Histol Histopathol. 2000;15:1293-301.
2. Rubin BP, Heinrich MC, Corless CL. Gastrointestinal stromal tumour. Lancet. 2007;369:1731-41.
https://doi.org/10.1016/S0140-6736(07)60780-6
3. Worley TA, Abadin SS, Revesz E, Salti GI. Gastrointestinal stromal tumor with hemoperitoneum masquerading as appendicitis. Int Surg. 2010;95:8-11.
4. Tran S, Dingeldein M, Mengshol SC, Kay S, Chin AC. Incidental GIST after appendectomy in a pediatric patient: A first instance and review of pediatric patients with CD117 confirmed GISTs. Pediatr Surg Int. 2014;30:457-66.
https://doi.org/10.1007/s00383-013-3432-3
5. Corless CL, Fletcher JA, Heinrich MC. Biology of gastrointestinal stromal tumors. J Clin Oncol. 2004;22:3813-25.
https://doi.org/10.1200/JCO.2004.05.140
6. Tornillo L, Terracciano LM. An update on molecular genetics of gastrointestinal stromal tumours. J Clin Pathol. 2006;59:557-63.
https://doi.org/10.1136/jcp.2005.031112
7. Rahimi K, Gologan A, Haliotis T, Lamoureux E, Chetty R. Gastrointestinal stromal tumor with autonomic nerve differentiation and coexistent mantle cell lymphoma involving the appendix. Int J Clin Exp Pathol. 2008;2:608-13.
8. Miettinen M, Lasota J. Gastrointestinal stromal tumors-definition, clinical, histological, immunohistochemical, and molecular genetic features and differential diagnosis. Virchows Arch. 2001;438:1-12.
https://doi.org/10.1007/s004280000338
9. Nishida T, Takahashi T, Miyazaki Y. Gastrointestinal stromal tumor: A bridge between bench and bedside. Gastric Cancer. 2009;12:175-88.
https://doi.org/10.1007/s10120-009-0525-8
10. Miettinen M, Sobin LH. Gastrointestinal stromal tumors in the appendix: A clinicopathologic and immunohistochemical study of four cases. Am J Surg Pathol. 2001;25:1433-7.
https://doi.org/10.1097/00000478-200111000-00013
11. Vassos N, Agaimy A, Günther K, Hohenberger W, SchneiderStock R, Croner RS. A novel complex KIT mutation in a gastrointestinal stromal tumor of the vermiform appendix. Hum Pathol. 2013;44:651-5.
https://doi.org/10.1016/j.humpath.2012.09.003
12 Yap WM, Tan HW, Goh SG, Chuah KL. Appendiceal gastrointestinal stromal tumor. Am J Surg Pathol. 2005;29:1545-7.
https://doi.org/10.1097/01.pas.0000180445.79398.d4
13. Elazary R, Schlager A, Khalaileh A, Appelbaum L, Bala M, AbuGazala M, et al. Malignant appendiceal GIST: Case report and review of the literature. J Gastrointest Cancer. 2010;41:9-12.
https://doi.org/10.1007/s12029-009-9113-8
14. Miettinen M, Lasota J. Gastrointestinal stromal tumors: Pathology and prognosis at different sites. Semin Diagn Pathol. 2006;23:70-83.
https://doi.org/10.1053/j.semdp.2006.09.001
15. Agaimy A, Wünsch PH, Sobin LH, Lasota J, Miettinen M. Occurrence of other malignancies in patients with gastrointestinal stromal tumors. Semin Diagn Pathol. 2006;23:120-9.
https://doi.org/10.1053/j.semdp.2006.09.004
16. Burgoyne AM, Somaiah N, Sicklick JK. Gastrointestinal stromal tumors in the setting of multiple tumor syndromes. Curr Opin Oncol. 2014;26:408-14.
https://doi.org/10.1097/CCO.0000000000000089
17. Kover E, Faluhelyi Z, Bogner B, Kalmar K, Horvath G, Tornoczky T. Dual tumours in the GI tract: Synchronous and metachronous stromal (GIST) and epithelial/neuroendocrine neoplasms. Magy Onkol.2004;48:315-21.
18. Joensuu H. Risk stratification of patients diagnosed with gastrointestinal stromal tumor. Hum Pathol. 2008;39:1411-9.
https://doi.org/10.1016/j.humpath.2008.06.025
19. Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, et al. Diagnosis of gastrointestinal stromal tumors: A consensus approach. Hum Pathol. 2002;33:459-65.
https://doi.org/10.1053/hupa.2002.123545
20. Vassos N, Agaimy A, Hohenberger W, Croner RS. Extraabdominal lymph node metastasis in gastrointestinal stromal tumors (GIST). J Gastrointest Surg. 2011;15:1232-6.
https://doi.org/10.1007/s11605-011-1464-3
21. Joensuu H. Gastrointestinal stromal tumor (GIST). Ann Oncol. 2006;17(Suppl.10):280-6.
https://doi.org/10.1093/annonc/mdl274
22. Miettinen M, Lasota J. Gastrointestinal stromal tumors: Review on morphology, molecular pathology, prognosis, and differential diagnosis. Arch Pathol Lab Med. 2006;130:1466-78.
23. DeMatteo RP, Lewis JJ, Leung D. Two hundred gastrointestinal stromal tumors: Recurrence patterns and prognostic factors for survival. Ann Surg. 2000;231:51-8.
https://doi.org/10.1097/00000658-200001000-00008
24. Casali PG, Jost L, Reichardt P. Gastrointestinal stromal tumors: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol. 2008;19(Suppl.2):ii35-8.
https://doi.org/10.1093/annonc/mdn080
25. Chacón M, Roca E, Huertas E, Loria FS, Domenechini E. Pathologic complete remission of metastatic gastrointestinal stromal tumor after imatinibmesy late. J Clin Oncol. 2005;23:1580.
https://doi.org/10.1200/JCO.2005.03.194
26. Casali PG, Blay JY. Consensus Panel of Experts. Gastrointestinal stromal tumours: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2010;21(Suppl.5):v98-102.
https://doi.org/10.1093/annonc/mdq208
27. Láng I, Hitre E, Horváth Z, Godény M. Resection of originally inoperable liver metastases of gastrointestinal stromal tumor after imatinibmesy late therapy. J Clin Oncol. 2003;21:3538.
https://doi.org/10.1200/JCO.2003.03.176
28. Andtbacka RH, Ng CS, Scaife CL, Cormier JN, Hunt KK, Pisters PW, et al. Surgical resection of gastrointestinal stromal tumors after treatment with imatinib. Ann Surg Oncol. 2007;14:14.
https://doi.org/10.1245/s10434-006-9034-8
29. Acín-Gándara D, Pereira-Pérez F, Castaño-Pascual A, Durán-Poveda M, Antequera-Pérez A, Miliani-Molina C. Gastrointestinal stromal tumors: Diagnosis and treatment. Cir Cir. 2012;80:44-51.
30. Agaimy A, Wünsch PH, Dirnhofer S, Bihl MP, Terracciano LM, Tornillo L. Microscopic gastrointestinal stromal tumors in esophageal and intestinal surgical resection specimens: A clinicopathologic, immunohistochemical, and molecular study of 19 lesions. Am J Surg Pathol. 2008;32:867-73.
https://doi.org/10.1097/PAS.0b013e31815c0417
31. Bouassida M, Chtourou MF, Chalbi E, Chebbi F, Hamzaoui L, Sassi S, et al. Appendiceal GIST: Report of an exceptional case and review of the literature. Pan Afr Med J. 2013;15:85.
https://doi.org/10.11604/pamj.2013.15.85.2430
32. Agaimy A, Pelz AF, Wieacker P, Roessner A, Wünsch PH, Schneider-Stock R. Gastrointestinal stromal tumors of the vermiform appendix: Clinicopathologic, immunohistochemical, and molecular study of 2 cases with literature review. Hum Pathol. 2008;39:1252-7.
https://doi.org/10.1016/j.humpath.2007.12.016
33. Kim KJ, Moon W, Park MI, Park SJ, Lee SH, Chun BK. Gastrointestinal stromal tumor of appendix incidentally diagnosed by appendiceal hemorrhage. World J Gastroenterol. 2007;13:3265-7.
https://doi.org/10.3748/wjg.v13.i23.3265
2. Rubin BP, Heinrich MC, Corless CL. Gastrointestinal stromal tumour. Lancet. 2007;369:1731-41.
https://doi.org/10.1016/S0140-6736(07)60780-6
3. Worley TA, Abadin SS, Revesz E, Salti GI. Gastrointestinal stromal tumor with hemoperitoneum masquerading as appendicitis. Int Surg. 2010;95:8-11.
4. Tran S, Dingeldein M, Mengshol SC, Kay S, Chin AC. Incidental GIST after appendectomy in a pediatric patient: A first instance and review of pediatric patients with CD117 confirmed GISTs. Pediatr Surg Int. 2014;30:457-66.
https://doi.org/10.1007/s00383-013-3432-3
5. Corless CL, Fletcher JA, Heinrich MC. Biology of gastrointestinal stromal tumors. J Clin Oncol. 2004;22:3813-25.
https://doi.org/10.1200/JCO.2004.05.140
6. Tornillo L, Terracciano LM. An update on molecular genetics of gastrointestinal stromal tumours. J Clin Pathol. 2006;59:557-63.
https://doi.org/10.1136/jcp.2005.031112
7. Rahimi K, Gologan A, Haliotis T, Lamoureux E, Chetty R. Gastrointestinal stromal tumor with autonomic nerve differentiation and coexistent mantle cell lymphoma involving the appendix. Int J Clin Exp Pathol. 2008;2:608-13.
8. Miettinen M, Lasota J. Gastrointestinal stromal tumors-definition, clinical, histological, immunohistochemical, and molecular genetic features and differential diagnosis. Virchows Arch. 2001;438:1-12.
https://doi.org/10.1007/s004280000338
9. Nishida T, Takahashi T, Miyazaki Y. Gastrointestinal stromal tumor: A bridge between bench and bedside. Gastric Cancer. 2009;12:175-88.
https://doi.org/10.1007/s10120-009-0525-8
10. Miettinen M, Sobin LH. Gastrointestinal stromal tumors in the appendix: A clinicopathologic and immunohistochemical study of four cases. Am J Surg Pathol. 2001;25:1433-7.
https://doi.org/10.1097/00000478-200111000-00013
11. Vassos N, Agaimy A, Günther K, Hohenberger W, SchneiderStock R, Croner RS. A novel complex KIT mutation in a gastrointestinal stromal tumor of the vermiform appendix. Hum Pathol. 2013;44:651-5.
https://doi.org/10.1016/j.humpath.2012.09.003
12 Yap WM, Tan HW, Goh SG, Chuah KL. Appendiceal gastrointestinal stromal tumor. Am J Surg Pathol. 2005;29:1545-7.
https://doi.org/10.1097/01.pas.0000180445.79398.d4
13. Elazary R, Schlager A, Khalaileh A, Appelbaum L, Bala M, AbuGazala M, et al. Malignant appendiceal GIST: Case report and review of the literature. J Gastrointest Cancer. 2010;41:9-12.
https://doi.org/10.1007/s12029-009-9113-8
14. Miettinen M, Lasota J. Gastrointestinal stromal tumors: Pathology and prognosis at different sites. Semin Diagn Pathol. 2006;23:70-83.
https://doi.org/10.1053/j.semdp.2006.09.001
15. Agaimy A, Wünsch PH, Sobin LH, Lasota J, Miettinen M. Occurrence of other malignancies in patients with gastrointestinal stromal tumors. Semin Diagn Pathol. 2006;23:120-9.
https://doi.org/10.1053/j.semdp.2006.09.004
16. Burgoyne AM, Somaiah N, Sicklick JK. Gastrointestinal stromal tumors in the setting of multiple tumor syndromes. Curr Opin Oncol. 2014;26:408-14.
https://doi.org/10.1097/CCO.0000000000000089
17. Kover E, Faluhelyi Z, Bogner B, Kalmar K, Horvath G, Tornoczky T. Dual tumours in the GI tract: Synchronous and metachronous stromal (GIST) and epithelial/neuroendocrine neoplasms. Magy Onkol.2004;48:315-21.
18. Joensuu H. Risk stratification of patients diagnosed with gastrointestinal stromal tumor. Hum Pathol. 2008;39:1411-9.
https://doi.org/10.1016/j.humpath.2008.06.025
19. Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, et al. Diagnosis of gastrointestinal stromal tumors: A consensus approach. Hum Pathol. 2002;33:459-65.
https://doi.org/10.1053/hupa.2002.123545
20. Vassos N, Agaimy A, Hohenberger W, Croner RS. Extraabdominal lymph node metastasis in gastrointestinal stromal tumors (GIST). J Gastrointest Surg. 2011;15:1232-6.
https://doi.org/10.1007/s11605-011-1464-3
21. Joensuu H. Gastrointestinal stromal tumor (GIST). Ann Oncol. 2006;17(Suppl.10):280-6.
https://doi.org/10.1093/annonc/mdl274
22. Miettinen M, Lasota J. Gastrointestinal stromal tumors: Review on morphology, molecular pathology, prognosis, and differential diagnosis. Arch Pathol Lab Med. 2006;130:1466-78.
23. DeMatteo RP, Lewis JJ, Leung D. Two hundred gastrointestinal stromal tumors: Recurrence patterns and prognostic factors for survival. Ann Surg. 2000;231:51-8.
https://doi.org/10.1097/00000658-200001000-00008
24. Casali PG, Jost L, Reichardt P. Gastrointestinal stromal tumors: ESMO clinical recommendations for diagnosis, treatment and follow-up. Ann Oncol. 2008;19(Suppl.2):ii35-8.
https://doi.org/10.1093/annonc/mdn080
25. Chacón M, Roca E, Huertas E, Loria FS, Domenechini E. Pathologic complete remission of metastatic gastrointestinal stromal tumor after imatinibmesy late. J Clin Oncol. 2005;23:1580.
https://doi.org/10.1200/JCO.2005.03.194
26. Casali PG, Blay JY. Consensus Panel of Experts. Gastrointestinal stromal tumours: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2010;21(Suppl.5):v98-102.
https://doi.org/10.1093/annonc/mdq208
27. Láng I, Hitre E, Horváth Z, Godény M. Resection of originally inoperable liver metastases of gastrointestinal stromal tumor after imatinibmesy late therapy. J Clin Oncol. 2003;21:3538.
https://doi.org/10.1200/JCO.2003.03.176
28. Andtbacka RH, Ng CS, Scaife CL, Cormier JN, Hunt KK, Pisters PW, et al. Surgical resection of gastrointestinal stromal tumors after treatment with imatinib. Ann Surg Oncol. 2007;14:14.
https://doi.org/10.1245/s10434-006-9034-8
29. Acín-Gándara D, Pereira-Pérez F, Castaño-Pascual A, Durán-Poveda M, Antequera-Pérez A, Miliani-Molina C. Gastrointestinal stromal tumors: Diagnosis and treatment. Cir Cir. 2012;80:44-51.
30. Agaimy A, Wünsch PH, Dirnhofer S, Bihl MP, Terracciano LM, Tornillo L. Microscopic gastrointestinal stromal tumors in esophageal and intestinal surgical resection specimens: A clinicopathologic, immunohistochemical, and molecular study of 19 lesions. Am J Surg Pathol. 2008;32:867-73.
https://doi.org/10.1097/PAS.0b013e31815c0417
31. Bouassida M, Chtourou MF, Chalbi E, Chebbi F, Hamzaoui L, Sassi S, et al. Appendiceal GIST: Report of an exceptional case and review of the literature. Pan Afr Med J. 2013;15:85.
https://doi.org/10.11604/pamj.2013.15.85.2430
32. Agaimy A, Pelz AF, Wieacker P, Roessner A, Wünsch PH, Schneider-Stock R. Gastrointestinal stromal tumors of the vermiform appendix: Clinicopathologic, immunohistochemical, and molecular study of 2 cases with literature review. Hum Pathol. 2008;39:1252-7.
https://doi.org/10.1016/j.humpath.2007.12.016
33. Kim KJ, Moon W, Park MI, Park SJ, Lee SH, Chun BK. Gastrointestinal stromal tumor of appendix incidentally diagnosed by appendiceal hemorrhage. World J Gastroenterol. 2007;13:3265-7.
https://doi.org/10.3748/wjg.v13.i23.3265
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Publicado
2015-01-01
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Calle, Ángela M.; López, C. A. .; Sierra, J.; Ávila, A. . GIST Apendicular. Rev Colomb Cir 2015, 30, 56-61.
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