An atypical equine gastrointestinal stromal tumor

A 17-year-old, gelded Quarter Horse cross was found to have a large, intra-abdominal mass. Clinical signs included infrequent mild colic, weight loss, and chronic anemia. Surgery revealed a very large, discrete, hemorrhagic, multilobular mass with vascular attachments to the transverse colon, mesocolon, jejunal mesentery, and omentum; the site of origin was the transverse colon. Histologic examination demonstrated dense sheets, fascicles, palisades, and interconnecting streams of neoplastic spindle cells with lesser numbers of admixed multinucleated giant cells. Based on morphology alone, this neoplasm might have been misdiagnosed as a peripheral nerve sheath tumor because many of the morphologic features were suggestive of neural differentiation. Neoplastic cells expressed cluster of differentiation (CD)117 (c-kit), vimentin, desmin, smooth muscle actin, neuron-specific enolase, and S-100 protein and did not express cytokeratin. Based predominantly on the immunohistochemical profile, especially the CD117 positivity, this neoplasm was diagnosed as a gastrointestinal stromal tumor with both myogenic and neurogenic differentiation. The morphology and immunohistochemical profile of this neoplasm were different from published cases of equine gastrointestinal stromal tumors. Unusual aspects included the large size of this neoplasm, the neuroid rather than myxomatous morphology, the presence of multinucleated giant cells, and the expression of desmin.