• Guangsheng Zhu, Wenjia Sun, Yujun Liu, Huabin Wang, and Shengwei Ye.
• Department of Gastrointestinal Surgery, Hubei Cancer Hospital, Tongji Medical College, University of Science and Technology Huazhong, Wuhan, China.
• Medicine (Baltimore). 2021 Aug 27; 100 (34): e27011e27011.

RationaleGastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors of the gastrointestinal tract. Common sites for metastasis are the liver and peritoneum, whereas skeletal muscle metastases are rare.Patient ConcernsA 59-year-old man with skeletal muscle metastasis was diagnosed during a period of adjuvant imatinib therapy following the recurrence of GIST of the small intestine.DiagnosisThe patient was diagnosed with skeletal muscle metastasis of GIST based on immunohistochemistry and molecular pathology analysis results.InterventionExtensive resection of the left thigh tumor was performed. The patient underwent whole-exome sequencing of tissue examination. The results suggest that resistance to imatinib may have been developed, and the patient was therefore administered sunitinib instead.OutcomesComplete remission was observed following sunitinib therapy.LessonsIn cases of skeletal muscle metastasis diagnosed during a period of adjuvant imatinib therapy following the recurrence of a GIST of the small intestine, whole exome sequencing may be used to discover more gene variations.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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