Spinal Metastases from Gastrointestinal Stromal Tumor: A Case Report

Gastrointestinal stromal tumors (GISTs) arise from the interstitial cells of Cajal and are the most common form of gastrointestinal (GI) mesenchymal tumors. Bony metastasis is rare, with the spine being the most common location of osseous metastasis.

A 56-year-old female with presentation of acute on chronic mechanical low back pain was found to have multiple lytic lesions throughout the thoracolumbar spine arising from GIST metastases. Magnetic resonance imaging of the thoracic spine revealed a dorsal epidural enhancing mass spanning the T6-T8 levels with associated spinal cord compression and spinal cord signal change. The patient underwent urgent surgical decompression and resection of epidural tumor through T5-T8 decompressive laminectomy. Postoperatively, the patient initially did well with improvement in bilateral lower extremity sensation and bladder function. The patient passed away while at home due to undetermined causes 6 weeks postoperatively.

Here we present the case of a patient with metastatic GIST to the thoracic spine presenting with acute spinal cord compression treated with surgical resection, in addition to reviewing the literature of previous patients with metastatic GIST to the spine. We recommend that patients undergo surgical resection with adjuvant tyrosine kinase inhibitor therapy.