Introduction. Gastrointestinal stromal tumors (GISTs) are rare and account
for 0.1%-3% of all gastrointestinal neoplasms. GISTs are most commonly
located in the stomach (60%) and 20%-25% are malignant, with metastases
involving the peritoneum or the liver. Cystic liver metastases are extremely
rare. Only two previous cases of patients with cystic liver metastases,
prior to treatment with imatinib mesylate, have been described so far. Case
report. We reported a 52-year-old woman presented with a history of
abdominal fullness and discomfort. Clinical examination revealed two
palpable masses, first in the right upper abdomen and second left to the
umbilicus. Examinations revealed 4 cystic metastases in the liver, 3 in the
right lobe (including a huge one measuring 20.5 x 16 cm), and 1 in the left
lobe, together with a primary tumor on the greater curvature of the stomach.
Gastric tumor was removed with a Billroth II gastrectomy. Partial excision
of the largest liver metastasis was performed for histopathology.
Immunohistochemistry confirmed the diagnosis of a GIST in both tissue
samples. After an uneventful recovery the patient was commenced on imatinib
mesylate therapy. The patient remainsed symptom-free at 24 months follow-up.
Conclusion. This was the third reported case of gastric GIST with giant
cystic liver metastases present prior to treatment with imatinib mesylate.
Although extremely rare, GISTs may present with cystic liver metastases
prior to treatment with imatinib mesylate, and should be considered in the
differential diagnoses of patients with liver cysts of uncertain aetiology
