Surgical management of vertebral metastatic gastrointestinal stromal tumor: Case illustration, literature review, and pooled analysis

Surgical Neurology International
Yu Tung LoColum Patrick Nolan

Abstract

Gastrointestinal stromal tumors (GISTs) very rarely metastasize to the vertebrae. Tyrosine kinase inhibitors (TKIs) confer favorable long-term survival and durable disease control for metastatic disease. Here, we reviewed a case and the literature to determine the various management options, and neurological outcomes for these patients. A 63-year-old Chinese female with metastatic jejunal GIST previously treated with various TKIs presented with the left lower limb weakness and a sensory level at T10. MRI revealed a T9 vertebral body tumor with cord compression. The tumor was excised and surgical fixation was performed. She received 30Gy of fractionated adjuvant radiotherapy. She achieved near-complete neurological recovery but died 2 months later from systemic disease progression. Based on this case and a review of the literature, surgical intervention and treatment with TKIs with adjuvant RT can lead to comparable survival and neurological outcomes.

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