Open AccessDiscordant Primary Resistance to Imatinib Mesylate in the Same Individual and Splenic Involvement in Recurring Gastric Gastrointestinal Stromal Tumors: Assessment by Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography
Author(s) -
Preeti Fargose,
Sandip Basu
Publication year - 2018
Publication title -
indian journal of nuclear medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.261
H-Index - 13
eISSN - 0972-3919
pISSN - 0974-0244
DOI - 10.4103/ijnm.ijnm_142_17
Subject(s) - medicine , imatinib mesylate , stromal tumor , gist , stomach , radiology , positron emission tomography , fluorodeoxyglucose , differential diagnosis , primary tumor , metastasis , pathology , stromal cell , imatinib , cancer , myeloid leukemia
Discordant primary resistance and response of the metastatic lesions in the same individual coupled with splenic involvement in gastrointestinal stromal tumors (GISTs) are relatively uncommon. We herein report such a case of recurring GIST of the stomach that presented with the involvement of spleen with 18 F-fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT) imaging documentation. Ultrasonography-guided fine needle aspiration cytology from the splenic and paravesical lesions demonstrated metastatic spindle cell tumor consistent with diagnosis of metastasis from GIST of the stomach. The splenic and the paravesical lesions appeared resistant to the conventional 400 mg of imatinib mesylate, while most other abdominopelvic metastatic lesions demonstrated good metabolic response on FDG-PET/CT, with the noteworthy findings of interlesional heterogeneity of the metastatic lesions in terms of differential primary response in the same individual.