Killing two birds with one stone: a case of GIST and supervening CML.

A 50-year-old patient who presented with abdominal pain was found to have a suspicious 8 × 6 × 9 cm mass in the left upper abdomen on imaging. A complete surgical resection of the mass was performed subsequently and pathology revealed a gastrointestinal stromal tumour. The patient was started on adjuvant Imatinib following the resection. Four years later, reimaging demonstrated no evidence of disease and adjuvant therapy was discontinued. Nine months following discontinuation of Imatinib, routine blood work revealed marked leucocytosis. Further work up including peripheral smear and bone marrow biopsy showed findings consistent with chronic myelogenous leucaemia. Imatinib was restarted and the patient's white cell counts returned to normal range within a month. 2015 BMJ Publishing Group Ltd.