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A case of gastrointestinal stromal tumor diagnosed on prostate biopsy

Nature Clinical Practice Urology volume 6, pages 54–57 (2009)Cite this article

Abstract

Background A 56-year-old man initially presented to a local urologist with severe lower urinary tract symptoms and microhematuria. He had a history of hypertension, hyperlipidemia, mild asthma, gastroesophageal reflux disease, erectile dysfunction, and pyeloplasty as a child. Investigations at this time included urinalysis, measurement of serum PSA levels, cystoscopy, urine cytology, and renal ultrasonography. The findings were suggestive of benign prostatic hyperplasia, and the patient received finasteride, tamsulosin, and underwent transurethral needle ablation of the prostate. Four years after the initial presentation, the patient presented to a tertiary institution with worsened symptoms.

Investigations Upon re-presentation, investigations included measurement of serum PSA levels, pelvic CT, transrectal ultrasoundguided prostate biopsy, histological examination of the biopsy specimen and immunohistochemical staining.

Diagnosis Gastrointestinal stromal tumor.

Management Imatinib 400 mg daily followed by surgical resection.

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Figure 1: CT image demonstrating the 14 cm mass with heterogeneous enhancement emanating from the prostate (arrow).
Figure 2: Pathology of the patient's tumor.

References

  1. Hansel DE et al. (2007) Spindle cell lesions of the adult prostate. Mod Pathol 20: 148–158

    Article  CAS  Google Scholar 

  2. Rubin BP et al. (2007) Gastrointestinal stromal tumour. Lancet 369: 1731–1741

    Article  CAS  Google Scholar 

  3. Duffaud F and Blay JY (2003) Gastrointestinal stromal tumors: biology and treatment. Oncology 65: 187–197

    Article  Google Scholar 

  4. Kalender ME et al. (2007) Gastric and prostate adenocarcinoma in a patient with metastatic gastrointestinal stromal tumor. Onkologie 30: 568–570

    PubMed  Google Scholar 

  5. Agaimy A et al. (2006) Occurrence of other malignancies in patients with gastrointestinal stromal tumors. Semin Diagn Pathol 23: 120–129

    Article  Google Scholar 

  6. Van der Aa F et al. (2005) Gastrointestinal stromal tumor of the prostate. Urology 65: 388

    Article  Google Scholar 

  7. Lee CH et al. (2006) Gastrointestinal stromal tumor of the prostate: a case report and literature review. Hum Pathol 37: 1361–1365

    Article  Google Scholar 

  8. Van der Aa F et al. (2003) Interstitial cells in the human prostate: a new therapeutic target? Prostate 56: 250–255

    Article  Google Scholar 

  9. Madden JF et al. (2005) Anterior rectal wall gastrointestinal stromal tumor presenting clinically as prostatic mass. Urol Oncol 23: 268–272

    Article  Google Scholar 

  10. Herawi M et al. (2006) Gastrointestinal stromal tumors (GISTs) on prostate needle biopsy: a clinicopathologic study of 8 cases. Am J Surg Pathol 30: 1389–1395

    Article  Google Scholar 

  11. Druker BJ et al. (2001) Efficacy and safety of a specific inhibitor of the BCR–ABL tyrosine kinase in chronic myeloid leukemia. N Engl J Med 344: 1031–1037

    Article  CAS  Google Scholar 

  12. Demetri GD et al. (2002) Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med 347: 472–480

    Article  CAS  Google Scholar 

  13. National Comprehensive Cancer Network (online 28 May 2008) NCCN Clinical Practice Guidelines in Oncology™ Soft Tissue Sarcoma V.2.2008 [http://www.nccn.org/professionals/physician_gls/PDF/sarcoma.pdf] (accessed 10 November 2008)

  14. Schoonen WM et al. (2005) Alcohol consumption and risk of prostate cancer in middle-aged men. Int J Cancer 113: 133–140

    Article  CAS  Google Scholar 

  15. Bonvalot S et al. (2006) Impact of surgery on advanced gastrointestinal stromal tumors (GIST) in the imatinib era. Ann Surg Oncol 13: 1596–1603

    Article  CAS  Google Scholar 

  16. Antonescu CR (2008) Targeted therapy of cancer: new roles for pathologists in identifying GISTs and other sarcomas. Mod Pathol 21 (Suppl 2): S31–S36

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The authors would like to thank Jonathan I Epstein, MD, and the Johns Hopkins Department of Pathology, for help with the preparation of the histologic slide featured in Figure 2.

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Author notes

  1. 600 N Wolfe Street, Marburg 1, Baltimore, MD 21287, USA stacyloeb@gmail.com

Authors and Affiliations

  1. S Loeb is a Urology Resident at the Department of Urology, TL Lotan is a Fellow in Pathology at the Department of Pathology, K Thornton is an Assistant Professor of Medical Oncology at the Department of Oncology, and MP Schoenberg is a Professor of Urology and Oncology at the Department of Urology, SL Gearhart is an Assistant Professor of Colorectal Surgery, Johns Hopkins Medical Institutions, Baltimore, MD, USA.,

    Stacy Loeb, Tamara L Lotan, Katherine Thornton, Susan L Gearhart & Mark P Schoenberg

Authors
  1. Stacy Loeb
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  2. Tamara L Lotan
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  3. Katherine Thornton
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  4. Susan L Gearhart
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  5. Mark P Schoenberg
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The authors declare no competing financial interests.

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Loeb, S., Lotan, T., Thornton, K. et al. A case of gastrointestinal stromal tumor diagnosed on prostate biopsy. Nat Rev Urol 6, 54–57 (2009). https://doi.org/10.1038/ncpuro1264

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