Primary hepatic gastrointestinal stromal tumor with right adrenal gland invasion

Abstract

Introduction: Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors that mainly occur in the gastrointestinal tract. The GISTs that are sporadically reported in extra-gastrointestinal regions are named as extra-gastrointestinal stromal tumors (EGISTs). However, the primary EGISTs that originate from the liver are rare. Patient Concerns: A 64-year-old female presenting with right upper abdominal pain and thirsty for more than 20 days. Diagnosis: A diagnosis of a 15\u200a×\u200a14\u200a×\u200a7\u200acm liver mass located in the posterior right lobe of liver and spread to the right adrenal gland was confirmed. Pathological results showed that the tumor was mainly composed of epithelial cells and tested positive for CD117 and SDHB (succinate dehydrogenase complex iron sulfur subunit B). The gene mutational analyses for c-Kit and platelet-derived growth factor receptor alpha exons revealed negative results. Fluorescence in situ hybridization of murine double minute 2 produced negative fluorescence results which distinguished it from dedifferentiated liposarcomas. The postoperative gastroduodenal and colorectal endoscopy did not find any neoplastic lesions. To this end, the diagnosis of primary hepatic EGIST of wild type nature was confirmed. Interventions: The patient received right hepatectomy and adrenalectomy, no postoperative chemotherapy was administered. Outcomes: The patient died 11 months after surgery due to tumor metastasis. Conclusion: Primary hepatic EGIST is a rare and complicated disease of liver, a multidisciplinary team is necessary in diagnosis and treatment of primary hepatic EGIST.