engleski

First Report of Connexin 43-Positive Gastrointestinal Stromal Tumor (GIST)

Gastrointestinal stromal tumors (GISTs) are mesenchymal neoplasms most frequently found in stomach presenting without symptoms or unspecific ones due to hemorrhage and abdominal pain. Malignant potential of GIST is variable and there are several prognostic indexes for treatment and follow up. The superior diagnostic method is endoscopic ultrasound combined with fine needle aspiration biopsy (EUS- FNA) immunocytochemistry. Surgery is desired treatment option while recurrent or advanced disease is best managed with thyrosine kinase inhibitors. We report a case of 20 years old adult man present with gastrointestinal bleeding and anemia. Upper gastrointestinal endoscopy detected submucosal lesion and computerized tomography revealed a node beside the liver. EUS-FNA immunocytochemistry found CD -117 positive cells suggestive for GIST and the patient was operated on. Diagnose was confirmed by patohystology with immunostaining. Prognostic assessment was done according to tumor size, Ki-67 index with mitoses count on microscopy. Large number of studies has shown that tumors demonstrate an abnormal number, structure, occurrence of connexin proteins with alternated connexin-mediated intercellular communication. Since great deal of gastroenterological tumors express connexin 43, our aim was to find whether it was present in GIST. Immunohistochemically tumor was positive for connexin Cx-43, which was not earlier described as typical. Postoperative outcome was favorable managing clear margins resection, without procedural complications. At three-years postoperative follow-up patient was subjectively well, and without clinical signs of disease recurrence.

gastrointestinal stromal tumor GIST; endoscopy ultrasound EUS; fine needle aspiration biopsy FNA immunocytochemistry; Cx-43 connexin; anemia

nije evidentirano