A team of researchers found that nearly 24% of gastrointestinal stromal tumor (GIST) patients had a second neoplasm, according to a case series published in Pathology – Research and Practice.

Researchers from the Central Clinical Hospital of the Ministry of Interior and the Lazarski University in Warsaw, Poland, conducted a single-institution retrospective analysis of 76 GIST cases. Among the 18 patients with co-occurring tumors, they found that 11 had a metachronous diagnosis and 7 had a synchronous diagnosis.

“The occurrence of secondary tumors in our study group is two times higher than the estimated probability of developing a second tumor in the general population, which is assessed for 11.0%,” the authors said.

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Most concomitant neoplasms were breast (n=4) and gastric (n=4) cancers, followed by prostate (n=3) and skin (n=3) cancers. Most (52.6%) co-occurring GISTs were detected in the small intestine.

Out of the 18 co-occurring cases, most (77.8%, n=14) patients had very low or low-risk GISTs, 3 (16.7%) had moderate-risk GISTs, and 1 (5.6%) had a high-risk GIST.

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The development of a second neoplasm might have important implications in the prognosis of GIST patients. Though this topic remains under investigation, available data suggest that patients with concomitant tumors might have a worse prognosis. This suggests GIST patients should be carefully followed up and monitored for coexisting tumors.

To date, no association was established between the risk of developing a second neoplasm and clinical or histopathological features of GIST patients. However, several hypotheses have been mentioned, including the genetic profile of patients and common risk factors.

“There is a huge need to draw the attention of clinicians, as well as histopathologists to the phenomenon,” the authors advised. Since most concomitant tumors occurred metachronously, long-term follow-up studies are essential.


Szczepaniak K, Nasierowska-Guttmejer A. The occurrence of gastrointestinal stromal tumors with second malignancies – case series of a single institution experience. Pathol – Res Pract. 2021;228:153662. doi:10.1016/j.prp.2021.153662