Hepatic gastrointestinal stromal tumor: Systematic review of an exceptional location

Table 1 Clinical characteristics and location in selected patients with extra-gastrointestinal stromal tumor of the liver

Ref.	Yr	Age / Sex	Country	Presentation	Location	Size (cm)	Multifocal
Hu et al[20]	2018	79/F	China	Epigastric discomfort	RL	3.2	No
Joyon et al[21]	2018	56/M	France	Abdominal pain	Bilobar (Segments VII/VIII and LL)	10	Yes
	2018	59/F	France	Abdominal pain, weight loss	RL	23	No
Carrillo et al[22]	2017	41/M	Spain	Abdominal pain, weight loss	RL (S. V-VI)	20	No
Lok et al[23]	2017	50/F	China	Abdominal pain	RL	15	Yes
Cheng et al[24]	2016	63/M	China	No symptoms	RL	15	No
Nagai et al[25]	2016	70/F	Japan	Follow-up gastric cancer, No symptoms	LL	6	No
Liu et al[26]	2016	NA	China	NA	NA	NA	NA
Wang et al[27]	2016	61/M	China	No symptoms	Caudate lobe	7.3	No
Liu et al[28]	2016	56/F	China	No symptoms	LL + Pancreas	2.2	No
Su et al[29]	2015	65/M	Taiwan	Malaise, loss of apetite, abdominal pain	LL	12	No
Bhoy et al[3]	2014	41/F	India	Abdominal pain, weight loss	RL (S.VI-VI) I	15	Yes
Lin et al[30]	2015	67/F	China	No symptoms	RL	7.4	No
Mao et al[31]	2015	60/F	China	No symptoms	Bilobar (S I, IV, V, VIII)	12.8	No
Kim et al[32]	2014	71/M	Korea	Study for early gastric cancer, No symptoms	LL	7	No
Louis et al[33]	2014	55/F	India	Abdominal pain, loss of apetite	Bilobar (SII, III, VI, VIII)	14.5	Yes
Zhou et al[34]	2014	56/M	China	No symptoms	RL	10	No
Li et al[35]	2012	53/M	China	Abdominal discomfort	RL	20	No
Yamamoto et al[36]	2010	70/M	Japan	Loss of apetite (12 years after gastric cancer)	LL	20	No
Luo et al[37]	2009	17/M	China	No symptoms	RL	5	No
Ochiai et al[38]	2009	30/M	Japan	Abdominal fullnes	Bilobar	27	No
De Chiara et al[1]	2006	37/M	Italy	No symptoms	RL (SV)	18	No
Hu et al[6]	2003	79/F	USA	Shortness of breath, pleuritic chest pain	RL	15	No

M: Male; F: Female; RL: Right lobe; LL: Left lobe; NA: Not available.

Table 2 Diagnostic characteristics in selected patients with extra-gastrointestinal stromal tumor of the liver

Ref.	Yr	Age / Sex	Endoscopy	Imaging	Biopsy
Hu et al[20]	2018	79/F	Yes (no findings)	CT	No
Joyon et al[21]	2018	56/M	NA	CT	Percutaneous
	2018	59/F	Yes (no findings)	CT	Guided
Carrillo et al[22]	2017	41/M	Yes (no findings)	CT / MRI	No
Lok et al[23]	2017	50/F	Yes (no findings)	CT	No
Cheng et al[24]	2016	63/M	NA	CT	No
Nagai et al[25]	2016	70/F	Yes (no findings)	CT / MRI	No
Liu et al[26]	2016	NA	NA	NA	NA
Wang et al[27]	2016	61/M	NA	CT	No
Liu et al[28]	2016	56/F	NA	CT	Surgical
Su et al[29]	2015	65/M	NA	CT	CT-guided
Bhoy et al[3]	2014	41/F	NA	US/ CT	FNA
Lin et al[30]	2015	67/F	Yes (no findings)	CT	No
Mao et al[31]	2015	60/F	Yes (no findings)	CT / MRI	No
Kim et al[32]	2014	71/M	Early gastric cancer	CT / MRI	No
Louis et al[33]	2014	55/F	NA	CT	US-FNA/CT-FNA
Zhou et al[34]	2014	56/M	Yes (no findings)	NA	No
Li et al[35]	2012	53/M	NA	CT	US-FNAB
Yamamoto et al[36]	2010	70/M	NA	CT	No
Luo et al[37]	2009	17/M	NA	CT/US	US-FNA
Ochiai et al[38]	2009	30/M	NA	CT/ MRI	No
De Chiara et al[1]	2006	37/M	NA	CT	No
Hu et al[6]	2003	79/F	NA	CT	No

M: Male; F: Female; RL: Right lobe; NA: Not available; US: Ultrasound; CT: Computerized tomography; MRI: Magnetic resonance image; FNA: Fine needle aspiration.

Table 3 Treatment and adjuvant treatment in selected patients with extra-gastrointestinal stromal tumor of the liver

Ref.	Yr	Age / Sex	Treatment	Adjuvant imatinib mesylate
Hu et al[20]	2018	79/F	Curative surgical resection	Yes
Joyon et al[21]	2018	56/M	OLT	No
	2018	59/F	Refused surgery: imatinib mesylate	No
Carrillo et al[22]	2017	41/M	Segmentectomy V-VI	Yes
Lok et al[23]	2017	50/F	Right hepatectomy	Yes
Cheng et al[24]	2016	63/M	Right hepatectomy	Yes
Nagai et al[25]	2016	70/F	Left lateral segmentectomy	No
Liu et al[26]	2016	NA	NA	NA
Wang et al[27]	2016	61/M	Caudate lobe resection	No
Liu et al[28]	2016	56/F	Microwave ablation	Yes
Su et al[29]	2015	65/M	Irresecable: imatinib mesylate	No
Bhoy et al[3]	2014	41/F	Right hepatectomy	Yes
Lin et al[30]	2015	67/F	Surgical excision	Yes
Mao et al[31]	2015	60/F	ECHRA	Yes
Kim et al[32]	2014	71/M	Left lateral segmentectomy+excision of 1 intrabadominal nodule+total gastrectomy	NA
Louis et al[33]	2014	55/F	Segmentectomy III and atypical resection (segments II, VI and VIII)	Yes
Zhou et al[34]	2014	56/M	Anterior and median segmentectomy	No
Li et al[35]	2012	53/M	Refused treatment	No
Yamamoto et al[36]	2010	70/M	Left hepatectomy	NA
Luo et al[37]	2009	17/M	RFA	NA
Ochiai et al[38]	2009	30/M	L-Trisegmentectomy	Yes
De Chiara et al[1]	2006	37/M	NA	No
Hu et al[6]	2003	79/F	Right lobectomy	NA

M: Male; F: Female; OLT Ortotopic liver transplantation; ECHRA Extracorporeal hepatic resection and autotransplantation; NA: Not available; RFA: Radiofrequency ablation.

Table 4 Pathological, immunohistochemical and molecular findings, and risk of malignancy according to Fletcher et al[2]

Ref.	Yr	Age / Sex	Cell type	Molecular analysis	Mitotic count (nº / 50 HPF)	IH	Risk of malignancy
Hu et al[20]	2018	79/F	Spindle cells	NA	NA	CD117+, CD34+	NA
Joyon et al[21]	2018	56/M	Spindle cells	NA	8	CD117+, CD 34+	High risk
	2018	59/F	Mixed (spindle and epithelioid)	6 bp deletion in KIT exon 11	42	CD117+	High risk
Carrillo et al[22]	2017	41/M	Spindle cells	9 deletion in KIT	5	CD 117+, CD 34-	High risk
Lok et al[23]	2017	50/F	Spindle cells	NA	70	CD117+, CD 34+	High risk
Cheng et al[24]	2016	63/M	Spindle cells	NA	>5	CD 117 +, CD 34-	High risk
Nagai et al[25]	2016	70/F	Spindle cells	NA	40	CD117+, CD 34+	High risk
Liu et al[26]	2016	NA	NA	NA	NA	NA	NA
Wang et al[27]	2016	61/M	Spindle cells	NA	NA	CD117+/CD34+	High risk
Liu et al[28]	2016	56/F	Spindle cells	NA	2	CD117+	Low risk
Su et al[29]	2015	65/M	Spindle cells	NA	5	CD117+, CD 34-	High risk
Bhoy et al[3]	2014	41/F	NA	NA	NA	CD 117+	High risk
Lin et al[30]	2015	67/F	Mixed (spindle and epithelioid)	Mutation in exon 11	8	CD117+, CD 34+	High risk
Mao et al[31]	2015	60/F	Spindle cells	Mutation in exon 11	>10	CD 117+, CD 34 -	High risk
Kim et al[32]	2014	71/M	Spindle cells	NA	30-32	CD117+	High risk
Louis et al[33]	2014	55/F	Spindle cells	NA	10	CD117+	High risk
Zhou et al[34]	2014	56/M	Spindle cells	NA	<5	CD117+/CD34+	Intermediate
Li et al[35]	2012	53/M	Spindle cells	NA	NA	CD117+, CD34+	High risk
Yamamoto et al[36]	2010	70/M	Epithelioid cells	mutation PDGFRA exon 12	1	CD 117-/CD34+	High risk
Luo et al[37]	2009	17/M	Spindle cells	NA	0	CD117+, CD 34+	Low risk
Ochiai et al[38]	2009	30/M	Mixed (spindle and epithelioid)	No mutation at exon 11	75	CD117+, CD 34+	High risk
De Chiara et al[1]	2006	37/M	Spindle cells	NA	20	CD117+, CD 34+	High risk
Hu et al[6]	2003	79/F	Spindle cells	NA	20	CD117+, CD 34+	Low risk

M: male; F: female; NA: not available; PDGFRA: Platelet derived Growth Factor Receptor Alpha; HPF: High Power Fields.

Table 5 Outcome and follow-up in selected patients with EGIST of the liver

Ref.	Yr	Outcome	Follow-up (mo)
Hu et al[20]	2018	NA	NA
Joyon et al[21]	2018	Local recurrence (12 yr)	252
	2018	DF	18
Carrillo et al[22]	2017	DF	18
Lok et al[23]	2017	Brain metastasis (6 mo)	6
Cheng et al[24]	2016	DF	30
Nagai et al[25]	2016	DF	10
Liu et al[26]	2016	NA	NA
Wang et al[27]	2016	DF	12
Liu et al[28]	2016	Abdominal metastasis	17
Su et al[29]	2015	Progression of disease (died 6 mo)	6
Bhoy et al[3]	2014	DF	5
Lin et al[30]	2015	Hepatic recurrence (24 mo)	72
Mao et al[31]	2015	DF	12
Kim et al[32]	2014	NA	NA
Louis et al[33]	2014	DF	6
Zhou et al[34]	2014	DF	12
Li et al[35]	2012	NA	NA
Yamamoto et al[36]	2010	NA	NA
Luo et al[37]	2009	DF	3
Ochiai et al[38]	2009	Hepatic recurrence, submucosal gastric tumor (24 mo)	25
De Chiara et al[1]	2006	Lung mestastasis (14 mo)	39
Hu et al[6]	2003	Portal lymph node mestastasis (16 mo)	16

NA: Not available; DF: Disease free.