Imatinib-induced haematuria necessitating drug discontinuation

2020 ◽  
Vol 4 (3) ◽  
pp. 121-123
Author(s):  
Anandu Hemakumar ◽  
Keechilat Pavithran
Keyword(s):  
Kinase Inhibitors ◽  
Advanced Disease ◽  
Gastrointestinal Stromal Tumour ◽  
Stromal Tumour ◽  
Drug Discontinuation ◽  
Gastrointestinal Stromal Tumours ◽  
Old Adult ◽  
History Of ◽  
Improvement In Survival ◽  
Gross Haematuria

Gastrointestinal stromal tumours are rare neoplasms of the gastrointestinal tract that are mesenchymal in origin. The introduction of tyrosine kinase inhibitors resulted in significant improvement in survival of patients with gastrointestinal stromal tumour even in advanced disease conditions. A 43-year-old adult male who is a known case of gastrointestinal stromal tumour of the stomach, on adjuvant therapy with imatinib, presented with a history of gross haematuria of several episodes as well as persistent microhaematuria and was evaluated for the same. He was investigated for all possible causes, but all were negative. The patient was advised to withhold imatinib. Haematuria resolved 1 month after stopping imatinib. Then it was rechallenged. He had recurrence of symptoms, so it was discontinued. In view of the temporal relation of haematuria and administration of imatinib, a diagnosis of imatinib-induced haematuria was made.

scholarly journals Unusual occurrence of two sister tumours in the same patient- gastrointestinal stromal tumour and gastrointestinal autonomic nerve tumour

2018 ◽  
Vol 5 (2) ◽  
pp. 752
Author(s):  
Abhijeet Bagul ◽  
Nandhkishore Narwade ◽  
Sridevi Murali ◽  
Yashraj Shah
Keyword(s):  
Case Reports ◽  
Gastrointestinal Stromal Tumour ◽  
Stromal Tumour ◽  
Autonomic Nerve ◽  
Gastrointestinal Stromal Tumours ◽  
Hereditary Syndromes ◽  
Gastrointestinal Tumours ◽  
Unusual Occurrence ◽  
Ileocecal Intussusception ◽  
Nerve Tumour

Gastrointestinal stromal tumours (GIST) account for less than 1% of gastrointestinal tumours, whereas Gastrointestinal autonomic nerve tumour (GANT) is a rare variant of gastrointestinal stromal tumour (GIST) and occurs at an estimated frequency of 1% of all malignant gastrointestinal tumours. We report the case of a 38-year old male which represents the rarity in the incidence of a Gastrointestinal Stromal tumour as well as the occurrence of a gastrointestinal autonomic nerve tumour together in the same patient which presented as a jejunal lump along with a terminal ileocecal intussusception. Multiple GISTs are associated with familial or hereditary syndromes are described only in few case reports whereas multiple sporadic GISTs have been rarely reported. This review aims to report the multiple sporadic occurrence of two types of GISTs as well as discuss highlight the features and prognosis of GANTs as surgeons and gastroenterologists are unaware of the existence of such an entity.

scholarly journals Refractory hypercalcaemia secondary to localised gastrointestinal stromal tumour

2018 ◽  
Vol 100 (6) ◽  
pp. e136-e138 ◽  
Author(s):  
T Hart ◽  
D Sinitsky ◽  
A Shamsiddinova ◽  
A Rohatgi
Keyword(s):  
Abdominal Pain ◽  
Abdominal Cavity ◽  
Gastrointestinal Stromal Tumour ◽  
Stromal Tumour ◽  
Unusual Complication ◽  
Treatment Resistant ◽  
Gastrointestinal Stromal Tumours ◽  
Rare Form ◽  
Abdominal Neoplasm ◽  
Mesenchymal Tissue

Gastrointestinal stromal tumours are a rare form of intra-abdominal neoplasm derived from mesenchymal tissue, typically presenting with abdominal pain, anaemia or bleeding into the bowel or abdominal cavity. Hypercalcaemia is an unusual complication, having been documented in only seven previous patients, all of whom had advanced metastatic disease. We present a case of treatment-resistant hypercalcaemia in a patient with non-metastatic gastrointestinal stromal tumour, which resolved following excision of the tumour.

A New Monoclonal Antibody that Blocks KIT Dimerisation and Inhibits Gastrointestinal Stromal Tumour Growth

2020 ◽  
Author(s):  
Chen Guang Bai ◽  
Yi Xu ◽  
Cen Qiu
Keyword(s):  
Monoclonal Antibody ◽  
Cell Growth ◽  
Tyrosine Kinase ◽  
Tyrosine Kinase Inhibitors ◽  
Kinase Inhibitors ◽  
Gastrointestinal Stromal Tumour ◽  
Signalling Pathway ◽  
Stromal Tumour ◽  
Growth Responses ◽  
Kit Mutation

Abstract Gastrointestinal stromal tumour (GIST) is the most common sarcoma of the gastrointestinal tract, and arises owing to oncogenic mutations in c-kit that result in constitutive auto-phosphorylation of KIT in the absence of ligand binding. Small-molecule tyrosine kinase inhibitors have shown good clinical activity by inhibiting ATP binding to the receptor. Unfortunately, majority of patients eventually develop drug resistance, which limits the long-term benefits of the tyrosine kinase inhibitors and poses a significant challenge in the clinical management of GIST. Here, we demonstrate c-kit mutation-driven KIT auto-dimerisation prior to tyrosine kinase phosphorylation as same as the procedure in ligand-dependent signalling pathway and describe a monoclonal antibody, KITMAb, with strong affinity to the dimerisation domain of KIT that blocks the important step in both the KIT signalling pathways. Treatment of KIT-dimer-expressing cells with the KITMAb slowed down cell growth. Furthermore, KITMAb reduced the proportion of cells in the proliferative phase (S+G2-M). Finally, we also demonstrate that KITMAb treatment accelerated cell apoptosis. These results indicate that KITMAb strongly inhibits KIT receptor dimerisation-mediated signalling pathway and cell growth responses in vitro. Further, the results suggest that treatment with KITMAb may be potentially therapeutic in imatinib-resistant GIST.

scholarly journals Novel case of a scleroderma-mimicking syndrome associated with gastrointestinal stromal tumour

2021 ◽  
Vol 14 (3) ◽  
pp. e240211
Author(s):  
Zaran Ahmad Butt ◽  
Wan Lin Ng ◽  
Kamal Osman ◽  
Donough Howard
Keyword(s):  
Kinase Inhibitors ◽  
Gastrointestinal Stromal Tumour ◽  
Symptomatic Improvement ◽  
Stromal Tumour ◽  
Newly Diagnosed ◽  
Rapid Improvement ◽  
Potential Efficacy ◽  
Surveillance Imaging ◽  
Gastric Mass ◽  
Fibrotic Disorders

We report a case of a 54-year-old man who developed an atypical systemic syndrome involving Raynaud’s phenomenon, pulmonary fibrosis and skin thickening. These features were initially suggestive of newly diagnosed scleroderma. However, he displayed atypical clinical features of same, antinuclear antibody was negative and symptoms were refractory to various immunosuppressive therapies. CT imaging revealed a gastric mass, which later proved to be a gastrointestinal stromal tumour (GIST). Resection of the GIST leads to minimal symptomatic improvement. Surveillance imaging 1 year later revealed metastatic deposits. He was subsequently initiated on imatinib therapy, which led to a rapid improvement in fibrotic changes within weeks. While there have been previous descriptions of paraneoplastic fibrotic disorders, this is the first description of a scleroderma mimic in the setting of a GIST. It highlights an important potential overlap in the pathogenesis of these disease processes and the potential efficacy of tyrosine kinase inhibitors for scleroderma-like fibrotic disorders.

scholarly journals Outstanding Response to Sorafenib in a Patient with Metastatic Gastrointestinal Stromal Tumour

2021 ◽  
pp. 1567-1573
Author(s):  
Charlotte Brinch ◽  
Marie Dehnfeld ◽  
Estrid Hogdall ◽  
Tim Svenstrup Poulsen ◽  
Anders Toxvaerd ◽  
...  
Keyword(s):  
Tyrosine Kinase ◽  
Kinase Inhibitors ◽  
Primary Tumour ◽  
Growth Factor Receptor ◽  
Gastrointestinal Stromal Tumour ◽  
Stromal Tumour ◽  
Correct Treatment ◽  
Imatinib Resistance ◽  
Term Survival ◽  
Mutation Analyses

Gastrointestinal stromal tumour (GIST) is the most common sarcoma and can be seen in any part of the gastrointestinal tract. The effect of tyrosine kinase inhibitors varies with mutation status in receptor tyrosine kinase KIT and in platelet-derived growth factor receptor A (<i>PDGFRA</i>). This case presents a 61-year-old man, diagnosed with an 11-cm GIST located at the stomach with a high risk of recurrence. The patient showed intolerance to imatinib shortly after introduction and subsequently progressed on sunitinib and nilotinib. The patient started fourth-line treatment with sorafenib with an impressive response to a point at which metastases intra-abdominally and in the liver could be resected. After surgery, sorafenib was restarted. Due to toxicity, sorafenib dose was reduced over time. The dose was insufficient to control the disease since a new recurrence was detected. Mutation analyses revealed a GIST harbouring a deletion of codon p.I843_D846del, located at <i>PDGFRA</i> exon 18, right next to the codon D842 where mutations are known leading to imatinib resistance. In this case, the GIST was highly sensitive to sorafenib, and the response was dose related. It is mandatory to perform mutation analyses on primary tumour and at recurrence in the decision-making of the correct treatment for the patient. In March 2021, the patient had been in treatment with sorafenib for 12.5 years and was still without signs of recurrence. A multidisciplinary approach was essential for the long-term survival of the patient in this case.

scholarly journals Abdominal cyst of unclear aetiology: gastrointestinal stromal tumour or reactivation of abdominal tuberculosis

2022 ◽  
Vol 15 (1) ◽  
pp. e245767
Author(s):  
Damini Saxena ◽  
Robert A Duncan ◽  
Robert R Faust ◽  
Anthony Campagna
Keyword(s):  
Abdominal Mass ◽  
Gastrointestinal Stromal Tumour ◽  
Abdominal Tuberculosis ◽  
Definitive Diagnosis ◽  
Stromal Tumour ◽  
Antituberculous Therapy ◽  
Spindle Cells ◽  
Inflammatory Processes ◽  
History Of ◽  
Abdominal Cyst

Differential diagnosis of a new abdominal mass is broad and includes infection, malignancy and other inflammatory processes. Definitive diagnosis may be challenging without invasive biopsy, as history, physical exam and imaging may be non-specific. A 69-year-old man with a history of abdominal tuberculosis presented with a new painful abdominal cyst consistent with reactivation of tuberculosis versus new malignancy. Investigations revealed 4+ acid-fast bacilli from the aspirate suggestive of tuberculosis, but no improvement was noted on antituberculous therapy. Core needle biopsy noted c-KIT-positive spindle cells, diagnostic for a gastrointestinal stromal tumour, while cultures grew non-tuberculous mycobacteria.

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