Journal des biomarqueurs moléculaires et du diagnostic

A Case of Pfetin Negative Gastrointestinal Stromal Tumor (GIST), Metastasized to the Liver Five Years after Surgery: A Surgical Challenge

Abstract

Shunsuke Sakuraba, Hajime Orita, Tomoaki Ito, Tomoyuki Kushida, Mutsumi Sakurada, Hiroshi Maekawa, Ryo Wada and Koichi Sato

Background: Despite complete resection, GIST sometimes recurs and/or metastasizes. Accurate prognosis is needed and various risk stratification methods have been discussed. We have reported Pfetin as a risk factor for recurrence of GIST. In this study, we report a case of Pfetin-negative GIST of the stomach which was classified as low risk according to Fletcher-classification, but metastasized to the liver five years after surgery and was completely removed.

Case presentation: A 60-year-old-man with abdominal pain and hematemesis was diagnosed with GIST of the stomach. Though the risk of recurrence was low according to Fletcher-classification, Pfetin expression was negative. We performed long term frequent medical follow-up, and five years after partial resection of the stomach, the GIST metastasized to the liver and we resected it completely.

Conclusions: We experienced a case of GIST of the stomach which was assessed as low risk, but was Pfetinnegative. Pfetin-negative status alone indicated poor prognosis for this GIST. Pfetin-negative status may be an independent biomarker indicating poor prognosis for GIST. In Pfetin-negative cases, it is desirable that long term frequent medical checkup be performed even if other factors suggest that the GIST is low risk. Early detection of recurrence can lead to effective treatment.