Positive DOG-1 GIST Malignant in Colon with Metastasis in Paraovary Tissues and Ascites Fluids


  • Dini Andri Utami Resident of Anatomical Pathology, Faculty of Medicine, Andalas University, Dr. M. Djamil Central General Hospital Padang
  • Aswiyanti Asri Anatomical Pathology Department, Faculty of Medicine, Andalas University, Dr. M. Djamil Central General Hospital Padang
  • Hera Novianti Anatomical Pathology Department, Faculty of Medicine, Andalas University, Dr. M. Djamil Central General Hospital Padang
  • Andi Friadi Sub Division of Gynecological Oncology, Obstetrics and Gynecology Department, Faculty of Medicine, Andalas University, Dr. M. Djamil Central General Hospital Padang




Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasm of gastrointestinal tract that originate from Interstitial Cell of Cajal (ICC). The correct diagnosis of GISTs is important for therapeutic reasons of imatinib. Recently, DOG-1 has been introduced as an important diagnostic marker with high sensitivity and specificity. We report a caseof 40 years old woman with pain and swollen stomach in left lower quadrant since four month before come to the hospital. Ultrasound examination showed hipoechoic lession in the posterior of uterus and ascites. Paraovarian mass attached to the transverse colon and ascites was found on surgery. Histopathology diagnosis was a mesenchymal stromal tumour suggestive malignant GIST. Citological examination of asites fluid show a malignancy metastases. Immunohistochemistry showed negative for c-kit and positive for DOG-1, the conclusion is a GIST. Immunohistochemistry examinations are important to make defenitive diagnosis for GIST.  C-kit-negative GIST sare still rare, but defenitive diagnosis must be made because related to target therapy. DOG 1 has been proven in 89% of c-kit-negative GIST and claimed more sensitive and spesific.

Keywords: GIST, c-kit, DOG-1, ICC, paraovary


Zhou Y. Coexistence of gastrointestinal stromal tumor, esophageal and gastric cardia carcinomas. World Journal of Gastroenterology [Internet]. 2013 [cited 2019 Jul 17];19(12):2005. Available from: http://www.wjgnet.com/1007-9327/full/v19/i12/2005.htm

Niazi AK, Kaley K, Saif MW. Gastrointestinal stromal tumor of colon: a case report and review of literature. Anticancer research. 2014;34(5):2547–2550.

Kang G-H, Srivastava A, Kim YE, Park H-J, Park CK, Sohn TS, et al. DOG1 and PKC-θ are useful in the diagnosis of KIT-negative gastrointestinal stromal tumors. Modern Pathology [Internet]. 2011 Jun [cited 2019 Jul 17];24(6):866–75. Available from: http://www.nature.com/articles/modpathol201111

Miettinen M, Lasota J. Gastrointestinal stromal tumors (GISTs): definition, occurrence, pathology, differential diagnosis and molecular genetics. Pol J Pathol. 2003;54(1):3–24.

Gaballa KM, Metwally IH, Refky B, AbdElKhalek M, Saleh S, Abdelaziz AM, et al. Ovarian gastrointestinal stromal tumor: does this diagnosis exist?. European journal of gynaecological oncology. 2017;38(1):147–149.

Foo WC, Liegl-Atzwanger B, Lazar AJ. Pathology of Gastrointestinal Stromal Tumors. Clinical Medicine Insights: Pathology [Internet]. 2012 Jan [cited 2019 Jul 25];5:CPath.S9689. Available from: http://journals.sagepub.com/doi/10.4137/CPath.S9689

King DM. The radiology of gastrointestinal stromal tumours (GIST). Cancer Imaging [Internet]. 2005 [cited 2019 Jul 25];5(1):150–6. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1665232/

Idema DLM, Daryanani D, Sterk LMT, Klaase JM. Collision Tumor of the Stomach: A Case of an Adenocarcinoma and a Gastrointestinal Stromal Tumor. Case Reports in Gastroenterology [Internet]. 2008 [cited 2019 Jul 17];2(3):456–60. Available from: https://www.karger.com/Article/FullText/129707

Odze RD, Goldblum JR. Odze and Goldblum surgical pathology of the GI tract, liver, biliary tract, and pancreas [Internet]. 2015 [cited 2019 Jul 20]. Available from: https://www.clinicalkey.com/dura/browse/bookChapter/3-s2.0-C20110697145

Van Roggen JFG. The histopathological differential diagnosis of gastrointestinal stromal tumours. Journal of Clinical Pathology [Internet]. 2001 Feb 1 [cited 2019 Jul 25];54(2):96–102. Available from: http://jcp.bmj.com/cgi/doi/10.1136/jcp.54.2.96

Sözütek D, Yanık S, Akkoca AN, Sözütek A, Özdemir ZT, Avşar ÇU, et al. Diagnostic and prognostic roles of DOG1 and Ki-67, in GIST patients with localized or advanced/metastatic disease. International journal of clinical and experimental medicine. 2014;7(7):1914.

Vij M, Agrawal V, Kumar A, Pandey R. Cytomorphology of gastrointestinal stromal tumors and extra-gastrointestinal stromal tumors: A comprehensive morphologic study. J Cytol [Internet]. 2013;30(1):8–12. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3643373/

Dudani S, Kalhan S, Sharma S, Gupta A. Gastrointestinal stromal tumours (GIST)-Pathology and clinical applications of recent molecular advances–A perspective review. Çağdaş Tıp Dergisi. 2014;4(2 EK):100–90.

Antonescu CR. Gastrointestinal stromal tumor (GIST) pathogenesis, familial GIST, and animal models. Seminars in Diagnostic Pathology [Internet]. 2006 May 1;23(2):63–9. Available from: http://www.sciencedirect.com/science/article/pii/S0740257006001390

Sahin S, Ekinci O, Seckin S, Dursun A. The diagnostic and prognostic utility of dog1 expression on gastrointestinal stromal tumors. Turkish Journal of Pathology [Internet]. 2016 [cited 2019 Jun 19]; Available from: http://www.turkjpath.org/doi.php?doi=10.5146/tjpath.2016.01376

GIST Treatment Guidelines | GIST Support International [Internet]. [cited 2019 Aug 13]. Available from: https://www.gistsupport.org/treatments/gist-treatment-guidelines/

Prognosis | GIST Support International [Internet]. [cited 2019 Aug 15]. Available from: https://www.gistsupport.org/about-gist/prognosis/

Saif MW, Siddiqui IA, Sohail MA. Management of ascites due to gastrointestinal malignancy. Annals of Saudi medicine. 2009;29(5):369–377.