CD117 is not always positive in infantile gastrointestinal stromal tumor
Jin Peng He, Jie Xiong Feng
2018
World Journal of Pediatrics
Gastrointestinal stromal tumors (GISTs) are rare in infants. GIST was presumed to originate from the interstitial cells of Cajal (ICC), which has been proven by their immunophenotype (CD117 positive). About 95% of GISTs express CD117 and 80% of GISTs also express CD34. They locate mostly in the stomach or the small intestine and usually cause obstruction [1] . The UK National Registry of Childhood Tumors reported the incidence of GISTs at 0.02 per million per year in children below the age of
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... years [2] . Here we will discuss a very rare case of infantile GIST with negative CD117 expression and make a review of literatures about its clinical, histopathological, and prognostic findings. A 2 month-21-day-old female infant was transferred to our hospital because of a right quadrant abdominal mass. Previous prenatal examination revealed no abnomalities. Abdominal ultrasonography revealed a hepatonephric mass (5.1 × 4.7 cm) filling the right abdominal space and presenting with internal gas signs (Fig. 1a, b) . Abdominal computed tomography imaging of the infant showed a mass locating between the liver and the right kidney (Fig. 1c) . Laparotomy showed an orbicular mass surrounding cecum with a size of 5 × 4 cm, extending from the wall of the cecum, but not intruding into the lumen. The bowel segment containing the mass was excised and an ileocecal anastomosis was performed. The pathological specimen showed a 5 × 4 × 4 cm mass surrounding the cecum. Microscopic examination of the tumor showed a spindle cell mesenchymal tumor and mild atypia (Fig. 1d, e) . The mitotic rate was 1 per 50 HPF with Ki-67 LI as 1%. The tumor was completely resected with a negative margin confirmed by pathological examination post-operation. The tumor bulk was composed mostly of spindle cells staining positive for CD34, vimentin, DOG1 and partly positive for S-100. The tumor stained negative for CD117, Caldesmon, smooth muscle actin, myoglobin, β-catenin and desmin. The girl survived without recurrence for three years. To our knowledge, this is the ninth case reported a GIST in infantile period [2] [3] [4] [5] [6] [7] [8] [9] , and the second case reported an infantile GIST in the cecum (Fig.
doi:10.1007/s12519-018-0123-0
pmid:29508357
fatcat:xwy73a3f4zcrzfef55w5p4l2xi