Background. A 71-year-old male patient was diagnosed as having a KIT-positive gastrointestinal stromal tumor located at the gastric antrum. With no signs of distant metastasis, the patient primarily underwent gastric surgery with antrectomy and Billroth-I-reconstruction. Owing to tumor size and mitotic index, the patient was considered at high risk of tumor relapse and thus was entered into a clinical trial to receive adjuvant imatinib treatment. 4 months after initiation of imatinib treatment, the patient presented with several newly discovered subcutaneous and intra-abdominal tumor lesions. Imatinib treatment had been tolerated well until then.
Investigations. Physical examination, blood tests, biopsies of the subcutaneous tumor lesions, tumor morphology and immunohistochemistry, PCR for the T-cell receptor γ genes, sequential CT and PET-CT.
Diagnosis. Monoclonal T-cell lymphoproliferative disorder, potentially induced by imatinib.
Management. Imatinib was stopped, after which the tumor lesions spontaneously regressed and, eventually, complete remission was achieved.
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Charles P. Vega, University of California, Irvine, CA, is the author of and is solely responsible for the content of the learning objectives, questions and answers of the MedscapeCME-accredited continuing medical education activity associated with this article.
Thomas Licht declares he receives grant/research support from Novartis. Justus Duyster declares he is a consultant for Novartis. The other authors, the Journal Editor L. Hutchinson and the CME questions author C. P. Vega declare no competing interests.
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Verbeek, M., Fend, F., Licht, T. et al. T-cell lymphoproliferative disorder potentially induced by imatinib in a patient with GIST. Nat Rev Clin Oncol 7, 116–119 (2010). https://doi.org/10.1038/nrclinonc.2009.218
Pharmacoepidemiology and Drug Safety (2010)