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Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. Substantial disease control and survival benefits are achieved by the use of imatinib and sunitinib in patients with advanced metastatic disease and by adjuvant imatinib after surgical resection of high-risk disease. These agents have been associated with adverse effects such as hypothyroidism. However, a new report involving an index GIST patient with refractory hypothyroidism questions that association.
The patient had prior surgical resection and therapy for liver recurrence with imatinib and sorafenib. Prior to the use of sunitinib, he had hypothyroidism that was refractory to thyroid hormone supplementation. Evaluation of his tu…