Gastrointestinal stromal tumours of the oesophagus: a clinicopathological and molecular analysis of 27 cases

Guhyun Kang, Yuna Kang, Kyung Hee Kim, Sang Yun Ha, Jung Yeon Kim, Young Mog Shim, Michael Heinrich, Kyoung Mee Kim, Christopher Corless

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Abstract

Aims: Gastrointestinal stromal tumours (GISTs) may arise anywhere in the gastrointestinal tract, but are rare in the oesophagus. We describe the clinical, pathological and molecular characteristics of 27 primary oesophageal GISTs, the largest series to date. Methods and results: DNA was extracted and exons 9, 11, 13 and 17 of KIT, exons 12, 14 and 18 of PDGFRA and exon 15 of BRAF were amplified and sequenced. Oesophageal GISTs occurred in 14 men and 13 women aged between 22 and 80 years (mean: 56 years). All 27 cases were immunohistochemically positive for KIT, and 92 and 47% co-expressed CD34 or smooth muscle actin, respectively. Fifteen (71% of analysed cases) harboured KIT exon 11 mutations and one case each had a mutation in KIT exon 13 (K642E) or BRAF exon 15 (V600E). Long-term follow-up data (median, 96.5 months) were obtained for 20 cases; two patients had metastases at presentation and seven had developed local recurrence and/or metastasis after surgery. A large tumour size (≥ 10 cm), high mitotic rate (> 5/5 mm2), presence of a deletion mutation in KIT exon 11 involving codons 557–558 and a positive microscopic margin were associated with recurrence and metastasis. The KIT mutations identified in oesophageal GISTs are similar to those observed in gastric GISTs. Conclusions: Complete surgical resection with clear margins is recommended, if technically feasible, and genotyping can help to improve diagnosis and further patient management in oesophageal GIST.

Original languageEnglish (US)
Pages (from-to)805-812
Number of pages8
JournalHistopathology
Volume71
Issue number5
DOIs
StatePublished - Nov 1 2017

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Gastrointestinal Stromal Tumors
Esophagus
Exons
Neoplasm Metastasis
Mutation
Recurrence
Sequence Deletion
Codon
Smooth Muscle
Gastrointestinal Tract
Actins
Stomach
DNA

Keywords

  • gastrointestinal stromal tumour
  • KIT
  • mutation
  • oesophagus
  • prognosis

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

Cite this

Gastrointestinal stromal tumours of the oesophagus : a clinicopathological and molecular analysis of 27 cases. / Kang, Guhyun; Kang, Yuna; Kim, Kyung Hee; Ha, Sang Yun; Kim, Jung Yeon; Shim, Young Mog; Heinrich, Michael; Kim, Kyoung Mee; Corless, Christopher.

In: Histopathology, Vol. 71, No. 5, 01.11.2017, p. 805-812.

Research output: Contribution to journalArticle

Kang, Guhyun ; Kang, Yuna ; Kim, Kyung Hee ; Ha, Sang Yun ; Kim, Jung Yeon ; Shim, Young Mog ; Heinrich, Michael ; Kim, Kyoung Mee ; Corless, Christopher. / Gastrointestinal stromal tumours of the oesophagus : a clinicopathological and molecular analysis of 27 cases. In: Histopathology. 2017 ; Vol. 71, No. 5. pp. 805-812.
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AU - Kim, Jung Yeon

AU - Shim, Young Mog

AU - Heinrich, Michael

AU - Kim, Kyoung Mee

AU - Corless, Christopher

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N2 - Aims: Gastrointestinal stromal tumours (GISTs) may arise anywhere in the gastrointestinal tract, but are rare in the oesophagus. We describe the clinical, pathological and molecular characteristics of 27 primary oesophageal GISTs, the largest series to date. Methods and results: DNA was extracted and exons 9, 11, 13 and 17 of KIT, exons 12, 14 and 18 of PDGFRA and exon 15 of BRAF were amplified and sequenced. Oesophageal GISTs occurred in 14 men and 13 women aged between 22 and 80 years (mean: 56 years). All 27 cases were immunohistochemically positive for KIT, and 92 and 47% co-expressed CD34 or smooth muscle actin, respectively. Fifteen (71% of analysed cases) harboured KIT exon 11 mutations and one case each had a mutation in KIT exon 13 (K642E) or BRAF exon 15 (V600E). Long-term follow-up data (median, 96.5 months) were obtained for 20 cases; two patients had metastases at presentation and seven had developed local recurrence and/or metastasis after surgery. A large tumour size (≥ 10 cm), high mitotic rate (> 5/5 mm2), presence of a deletion mutation in KIT exon 11 involving codons 557–558 and a positive microscopic margin were associated with recurrence and metastasis. The KIT mutations identified in oesophageal GISTs are similar to those observed in gastric GISTs. Conclusions: Complete surgical resection with clear margins is recommended, if technically feasible, and genotyping can help to improve diagnosis and further patient management in oesophageal GIST.

AB - Aims: Gastrointestinal stromal tumours (GISTs) may arise anywhere in the gastrointestinal tract, but are rare in the oesophagus. We describe the clinical, pathological and molecular characteristics of 27 primary oesophageal GISTs, the largest series to date. Methods and results: DNA was extracted and exons 9, 11, 13 and 17 of KIT, exons 12, 14 and 18 of PDGFRA and exon 15 of BRAF were amplified and sequenced. Oesophageal GISTs occurred in 14 men and 13 women aged between 22 and 80 years (mean: 56 years). All 27 cases were immunohistochemically positive for KIT, and 92 and 47% co-expressed CD34 or smooth muscle actin, respectively. Fifteen (71% of analysed cases) harboured KIT exon 11 mutations and one case each had a mutation in KIT exon 13 (K642E) or BRAF exon 15 (V600E). Long-term follow-up data (median, 96.5 months) were obtained for 20 cases; two patients had metastases at presentation and seven had developed local recurrence and/or metastasis after surgery. A large tumour size (≥ 10 cm), high mitotic rate (> 5/5 mm2), presence of a deletion mutation in KIT exon 11 involving codons 557–558 and a positive microscopic margin were associated with recurrence and metastasis. The KIT mutations identified in oesophageal GISTs are similar to those observed in gastric GISTs. Conclusions: Complete surgical resection with clear margins is recommended, if technically feasible, and genotyping can help to improve diagnosis and further patient management in oesophageal GIST.

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