Gastric gastrointestinal stromal tumor smaller than 20 mm with liver metastasis

Akira Aso, Eikichi Ihara, Hiroaki Kubo, Takashi Osoegawa, Takamasa Oono, Kazuhiko Nakamura, Tetuhide Ito, Yoshihiro Kakeji, Osada Mikako, Hedetaka Yamamoto, Tatsuhiro Oishi, Yayoi Oishi, Yoichi Hachitanda, Ryoichi Takayanagi

Research output: Contribution to journalArticlepeer-review

16 Citations (Scopus)


There have been no reports of gastric gastrointestinal stromal tumors (GISTs) <20 mm with distant metastasis. We report a case of a 15-mm gastric GIST with liver metastasis 1 year after surgical resection of the primary lesion. A 35-year-old man underwent routine esophagogastroduodenoscopy in July 2009. A submucosal tumor (SMT) <20 mm was incidentally detected at the posterior wall of the gastric body. Endoscopic ultrasound (EUS) indicated that it was a gastrointestinal mesenchymal tumor, including GIST, leiomyoma or schwannoma. He did not accept regular follow-up for this gastric SMT, therefore local laparoscopic excision was carried out in October 2009. The final pathological diagnosis after surgery was GIST, 15 mm in size, and a mitotic rate of 7/50 high-power fields, which did not indicate a high metastatic risk. The patient was followed up regularly without adjuvant chemotherapy. At 1 year after surgery, a space-occupying lesion ~15 mm was detected in the left lobe of the liver by abdominal ultrasound, where no mass lesion had been observed before surgery. To make a definite diagnosis of the hepatic mass lesion, EUS-guided fine-needle aspiration was performed, which demonstrated a metastatic liver tumor from a gastric GIST. Although this was a rare case, we should keep in mind that gastric GISTs do have a chance of malignant behavior, even if <20 mm.

Original languageEnglish
Pages (from-to)29-32
Number of pages4
JournalClinical Journal of Gastroenterology
Issue number1
Publication statusPublished - Feb 2013

All Science Journal Classification (ASJC) codes

  • Gastroenterology


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