|Videos|June 13, 2017
Unresectable Metastatic Gastrointestinal Stromal Tumor: Case 2
Unresectable Metastatic Gastrointestinal Stromal Tumor
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- A 65year-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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