Subcutaneous metastasis from a gastrointestinal stromal tumor of the stomach: a case report.

Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms of the stomach, which account for approximately 3.6% of all gastric tumors. They may or may not be malignant. Malignant GIST rarely metastasizes to distant organs. We report a case of a gastric GIST diagnosed in a 69- year-old woman presented with a synchronous subcutaneous paraumbilical metastasis. Computed tomography (CT) scan demonstrated a space-occupying lesion arising from the gastric wall with a second well-circumscribed lesion in the subcutaneous tissue which infiltrated the aponeurosis of the right rectus abdominis. The patient underwent total gastrectomy and resection of the subcutaneous mass. Pathologic examination of the gastric tumor and subcutaneous mass showed histological and immunohistochemical characteristics of a GIST. The patient succumbed on the 4th postoperative day. Gastric stromal tumor metastasis must be taken into consideration in the differential diagnosis of a palpable paraumbilical mass in a patient diagnosed with malignant GIST.

Alternative interventional multimodality therapies for the management of liver malignancies.

Primary and secondary liver tumors are highly malignant with a very high morbidity and mortality. Although surgical resection is generally accepted as the mainstay of treatment, only a small number of patients are suitable for curative resection. Interventional multimodality therapies provide an alternative to liver resection with minimal morbidity and mortality and quite promising outcomes. These include transcatheter arterial chemoembolization (TACE), percutaneous ethanol (PEI) or other injection techniques, radiofrequency ablation (RFA), microwave coagulation therapy (MCT), cryoablation and interstitial laser photocoagulation (ILP). Techniques, indications and outcomes are discussed.

Adamantinoma of tibia: a case of late local recurrence along with lung metastases.

Adamantinomas of long bones are rare primary low-grade malignant tumours composed of cells with epithelial and fibrous characteristics. Local recurrence, though scarce, occurs 5-15 years after the onset of diagnosis. We report a case of local recurrence of an adamantinoma localised in tibia, along with the presence of two lung metastases, 24 years after diagnosis and surgical therapy of the primary tumour. The local recurrence and the lung metastases were removed surgically. The patient remains free of the disease for 3 years.