Dedifferentiated gastrointestinal stromal tumour with features mimicking malignant PEComa/alveolar soft part sarcoma: An unusual type of morphological transformation following imatinib treatment

Purpose. Imatinib treatment causes muscle cramps in up to 40% of patients, but their pathogenesis is unknown. We present a case series illustrating an association between imatinib, relative hypocalcaemia, and the development of cramps.Patients. The index patient developed muscle spasms and cramps after receiving imatinib for gastrointestinal stromal tumour (GIST) for 5 months. The adjusted serum calcium had dropped to the lower limit of normal. The low serum calcium and muscle cramps improved on stopping imatinib and recurred on rechallenge. We reviewed the medical records of 16 further patients.Results. Two patients reported muscle cramps (12%). There was a rapid and sustained reduction in adjusted serum calcium in the first 6 months from 2.45 ± 0.11 mmol/L (mean ± SD) to 2.30 ± 0.08 mmol/L (p=0.025).Conclusion. Imatinib treatment of GIST is associated with reduction in serum calcium which may explain the development of neuromuscular symptoms. In patients receiving imatinib, serum electrolytes should be monitored and muscle cramps treated by correction of serum calcium, or an empirical trial of quinine sulphate.

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Abdominopelvic perivascular epithelioid cell sarcoma (malignant PEComa) mimicking gastrointestinal stromal tumour of the rectum

Histopathology ◽

10.1111/j.1365-2559.2005.01991.x ◽

2005 ◽

Vol 46 (1) ◽

pp. 115-117 ◽

Cited By ~ 36

Author(s):

M Evert ◽

E Wardelmann ◽

G Nestler ◽

H-U Schulz ◽

A Roessner ◽

...

Keyword(s):

Gastrointestinal Stromal Tumour ◽

Epithelioid Cell ◽

Stromal Tumour ◽

Cell Sarcoma ◽

Perivascular Epithelioid Cell ◽

Malignant Pecoma

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A 32-month follow-up study of nanovesicle concentrations in blood from 12 patients with gastrointestinal stromal tumour treated with imatinib

Biochemical Society Transactions ◽

10.1042/bst20120247 ◽

2013 ◽

Vol 41 (1) ◽

pp. 303-308 ◽

Cited By ~ 3

Author(s):

Eva Ogorevc ◽

Roman Štukelj ◽

Apolonija Bedina-Zavec ◽

Vid Šuštar ◽

Metka Šimundić ◽

...

Keyword(s):

Clinical Studies ◽

Clinical Status ◽

Gastrointestinal Stromal Tumour ◽

Stromal Tumour ◽

Favourable Effect ◽

Imatinib Treatment ◽

Blood Samples ◽

Follow Up Study ◽

Potential Indicator

Clinical studies have indicated that the NV (nanovesicle) concentration in blood samples is a potential indicator of clinical status and can be used to follow the development of the disease. For 32 months, we monitored the effect of imatinib treatment on NV concentrations in blood samples from 12 patients with GIST (gastrointestinal stromal tumour). The NV concentration before the treatment increased with respect to control by a factor of 3.5 on average (range 2.6–9.2). The first week after initiation of the treatment, the NV concentration increased considerably, by a factor of 13 on average (range 5.9–21.2), whereas on average, after 1 month, it decreased to the level of the control and remained at that level for at least 1.5 years. Recent assessment (after 2.5 years) showed a somewhat increased NV concentration, by a factor of 2 on average (range 0.7–3.9). Low NV concentrations in blood samples during the treatment reflect a favourable effect of imatinib in these patients and no remission of the disease was hitherto observed.

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