Nakajima Sanae, Sonoda Kentaro, Kadokawa Yoshio, Kawabe Atsushi, Yamamoto Tsuyoshi
Dept. of Surgery, Asahi University Murakami Memorial Hospital.
Gan To Kagaku Ryoho. 2009 Dec;36(13):2645-8.
We report a case of a large gastric gastrointestinal stromal tumor (GIST), which we were able to curatively resect after treatment with a daily dosage of 400 mg imatinib for 3 months. The patient was a 46-year-old man whose chief complaint was anemia. Historical diagnosis by endoscopic biopsy was a c-kit-positive GIST of the stomach. From a CT scan, it was suspected that the tumor had directly invaded the pancreas. The tumor was 9 cm in size. For this case, total gastrectomy with distal pancreato splenectomy was necessary for curative resection. Imatinib mesilate was administered as neoadjuvant therapy according to the NCCN guidelines. After 3 months of treatment, CT revealed a dramatic reduction in tumor diameter of 61% and showed direct invasion of the pancreas. The radical operation was considered feasible and a partial gastrectomy was performed. The tumor did not invade other organs, and radical surgery was possible without rupture. The patient was recurrence free at his 12-month follow-up examination.
我们报告一例大型胃胃肠道间质瘤（GIST）病例，该患者在每日服用400mg伊马替尼治疗3个月后得以根治性切除。患者为一名46岁男性，主要症状为贫血。内镜活检的既往诊断为胃c-kit阳性GIST。根据CT扫描，怀疑肿瘤已直接侵犯胰腺。肿瘤大小为9cm。对于该病例，为进行根治性切除，需要行全胃切除术加远端胰腺脾切除术。根据美国国立综合癌症网络（NCCN）指南，给予甲磺酸伊马替尼作为新辅助治疗。治疗3个月后，CT显示肿瘤直径显著缩小61%，且显示肿瘤直接侵犯胰腺。根治性手术被认为可行，遂行部分胃切除术。肿瘤未侵犯其他器官，可行根治性手术且未破裂。患者在12个月的随访检查中无复发。
