Multiple Gastrointestinal Stromal Tumors of Duodenum and Jejunum Accompanied by Lymph Node and Brain Metastasis: Report of a Case

Masaki Kajikawa, Akiharu Ishiyama, Kenro Sawada, Kenzo Ono* and Yasuhiko Suzuki*

Department of Surgery and Department of Pathology*, Tosei General Hospital

A 76-year-old man admitted for tarry stool and suspected of duodenal poorly differentiated adenocarcinoma in fiberscopic biopsy underwent pylorus-preserving pancreaticoduodenectomy in which surgical findings showed a duodenal tumor, 5 jejunal tumors, and mesenteric lymph node metastasis. Histopathological findings of positive immunohistochemical staining for KIT showed these tumors to be gastrointestinal stromal tumors (GIST). One month postoperatively, he suffered cramps and was diagnosed with multiple brain metastases. Although treated with whole-brain radiation and medicated with imatinib mesylate, he died 6 months after surgery. This extremely rare case involved GIST accompanied by lymph node and brain metastasis, suggesting the multiple modality of GIST.

Key words
gastrointestinal stromal tumor, lymph node metastasis, brain metastasis

Reprint requests
Masaki Kajikawa Department of Surgery, National Hospital Organization Nagoya Medical Center
4-1-1 Sannomaru, Naka-ku, Nagoya, 460-000 JAPAN

Accepted
January 26, 2005

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