ONCAlert | 2018 ASCO Annual Meeting
Gastrointestinal Stromal Tumors Case Studies

Case Studies: Unresectable Metastatic Gastrointestinal Stromal Tumor

In this case-based interview, Jonathan Strosberg, MD, discusses the treatment of advanced gastrointestinal stromal tumor.

Unresectable Metastatic Gastrointestinal Stromal Tumor: Case 2

  • A 65–year-old male presented with severe abdominal discomfort
    • Past medical history included mild back pain and joint pain that was treated with NSAIDs
  • Abdominal CT findings showed a large mass with a diameter of 14 cm involving the cardia, fundus, and body of the stomach; splenic involvement was also noted.
  • A small lesion was detected in the liver
  • Biopsy and histological examination confirmed that the mass was a gastrointestinal stromal tumor
    • IHC indicated that the tumor was positive for c-KIT
    • Genetic analyses showed a mutation in exon 11 of c-KIT
    • The tumor showed high mitotic activity with >5 mitoses/50 high-power fields
  • She was diagnosed with GIST of the stomach and liver metastasis
  • Treatment was initiated with neoadjuvant imatinib with the goal to achieve reduction of operative risk for the primary tumor and for functional preservation
    • The tumor size was reduced to 8 cm at 3 months and to 5 cm after 6 months
    • No further reduction was noted at 9 months
  • At 10 months, the patient underwent total gastrectomy, splenectomy, and partial hepatectomy
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