Ishikawa Akihisa, Teratani Takuma, Ono Satoshi, Ochiai Toshihiro, Kakinoki Nobushige, Kishimoto Yosuke, Kamoshida Toshirou, Hirai Shinji, Oka Yuji, Shimokama Tatsuro
Department of Gastroenterology, Hitachi General Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2006 Nov;103(11):1274-9.
A 58-year-old man was admitted because of perforation of the small intestine by a gastrointestinal stromal tumor (GIST). First, the small intestine including a GIST was resected; and then 2 month later, a part of the liver (S5) conforming to metastatic lesion was surgically removed. Twelve months later, another liver metastases was found, and surgical treatment was recommended; but the patient requested non-surgical therapy, so a radiofrequency ablation (RFA) was successfully performed. After that, recurrence of liver metastasis was not observed, but another metastasis was observed on the fifth lumbar vertebra; so administration of imatinib mesylate was started. 28 months after the initial administration the metastatic liver lesion was still invisible, and the bone metastatic lesion had not grown. The patient is alive with good performance status. This report shows that multi-modality therapy by surgery, RFA and imatinib mesylate was effective for liver and bone metastases of GIST.
一名58岁男性因胃肠道间质瘤(GIST)导致小肠穿孔入院。首先,切除包括GIST的小肠;2个月后,手术切除符合转移灶的部分肝脏(S5)。12个月后,发现另一处肝转移,建议手术治疗;但患者要求非手术治疗,因此成功进行了射频消融(RFA)。此后,未观察到肝转移复发,但在第五腰椎发现另一处转移;于是开始给予甲磺酸伊马替尼治疗。初始给药28个月后,转移性肝病灶仍不可见,骨转移病灶未生长。患者存活,身体状况良好。本报告表明,手术、RFA和甲磺酸伊马替尼的多模式治疗对GIST的肝转移和骨转移有效。