open access

Vol 5, No 3 (2009)
Case report
Published online: 2009-05-15
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Synchronous appearance of gastrointenstinal stromal tumor and myeloma plasmocyticum with c-kit expression - a case report

Ryszard Pogłód, Maria Kraj, Beata Kwaśniak, Renata Maryniak, Ewa Kalinka-Warzocha, Krzysztof Warzocha
Onkol. Prak. Klin 2009;5(3):109-113.

open access

Vol 5, No 3 (2009)
CASE REPORTS
Published online: 2009-05-15

Abstract

We report a case of a 60-year-old man in whom synchronous appearance of gastrointenstinal stromal tumor (GIST) and myeloma plasmocyticum (MP) with c-kit expression on both tumors. The treatment of MP with VAD (vincristine, adriamycin, dexamethasone), followed by a 9-month administration of thalidomide, combined with melphalan and dexamethasone given once a month, resulted in achieving and maintaining partial remission (PR) for 14 months. The therapy of GIST included a total resection of the tumor and, after tumor metastasizing within abdominal cavity, systemic treatment with c-kit kinase inhibitors. Both 2-month imatinib administration and 2.5-month sunitinib therapy were unsuccessful. The patient died 18 months since diagnosis of both tumors due to progression of GIST, in PR of myeloma. A simultaneous occurrence meof both tumors excludes carcinogenic effect of therapy. Expression of c-kit by cells of both malignancies may suggest one oncogenic event, namely c-kit mutation, in pathogenesis of both tumors. It is also worthy to stress different response of MM and GIST to treatment. This case raises also the question of potential cross-effect of targeted and immunomodulatory therapies on synchronous and/or metachronous neoplasms'clinical course.

Abstract

We report a case of a 60-year-old man in whom synchronous appearance of gastrointenstinal stromal tumor (GIST) and myeloma plasmocyticum (MP) with c-kit expression on both tumors. The treatment of MP with VAD (vincristine, adriamycin, dexamethasone), followed by a 9-month administration of thalidomide, combined with melphalan and dexamethasone given once a month, resulted in achieving and maintaining partial remission (PR) for 14 months. The therapy of GIST included a total resection of the tumor and, after tumor metastasizing within abdominal cavity, systemic treatment with c-kit kinase inhibitors. Both 2-month imatinib administration and 2.5-month sunitinib therapy were unsuccessful. The patient died 18 months since diagnosis of both tumors due to progression of GIST, in PR of myeloma. A simultaneous occurrence meof both tumors excludes carcinogenic effect of therapy. Expression of c-kit by cells of both malignancies may suggest one oncogenic event, namely c-kit mutation, in pathogenesis of both tumors. It is also worthy to stress different response of MM and GIST to treatment. This case raises also the question of potential cross-effect of targeted and immunomodulatory therapies on synchronous and/or metachronous neoplasms'clinical course.
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Keywords

gastrointenstinal stromal tumor; myeloma plasmocyticum; c-kit; diagnosis; treatment

About this article
Title

Synchronous appearance of gastrointenstinal stromal tumor and myeloma plasmocyticum with c-kit expression - a case report

Journal

Oncology in Clinical Practice

Issue

Vol 5, No 3 (2009)

Article type

Case report

Pages

109-113

Published online

2009-05-15

Bibliographic record

Onkol. Prak. Klin 2009;5(3):109-113.

Keywords

gastrointenstinal stromal tumor
myeloma plasmocyticum
c-kit
diagnosis
treatment

Authors

Ryszard Pogłód
Maria Kraj
Beata Kwaśniak
Renata Maryniak
Ewa Kalinka-Warzocha
Krzysztof Warzocha

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