Department of Gastroenterological Surgery, Cancer Institute Hospital, 3-10-6 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Surg Today. 2010 Mar;40(3):272-6. doi: 10.1007/s00595-008-4037-7. Epub 2010 Feb 24.
A 70-year-old woman with a pelvic tumor had undergone exploratory laparoscopy at another institution, which revealed many peritoneal nodules. Immunohistochemical staining of a biopsy specimen of the peritoneal nodules was positive for KIT. Thus, a gastrointestinal stromal tumor (GIST) was diagnosed and imatinib treatment was begun. After 16 months of this treatment, the tumor size had decreased from 51 x 55 mm to 22 x 17 mm, and surgery was performed. Laparotomy revealed complete regression of the peritoneal lesions. The primary tumor was seen to arise from the small intestine and to loosely adhere to the rectum. We performed partial resection of the small intestine. Imatinib therapy was restarted 1 month postoperatively, and the patient is doing well after 12 months of follow-up. We report this case to show that there is the possibility of curative salvage surgery after long-term imatinib treatment in some patients with peritoneal metastases of a GIST.
一位 70 岁的女性因盆腔肿瘤在另一家机构接受了腹腔镜探查术，术中发现许多腹膜结节。腹膜结节活检标本的免疫组织化学染色为 KIT 阳性。因此，诊断为胃肠道间质瘤（GIST）并开始使用伊马替尼治疗。治疗 16 个月后，肿瘤大小从 51x55mm 缩小至 22x17mm，遂进行了手术。剖腹探查显示腹膜病变完全消退。原发肿瘤位于小肠并与直肠轻度粘连。我们进行了小肠部分切除术。术后 1 个月重新开始伊马替尼治疗，随访 12 个月后患者情况良好。我们报告此病例是为了表明，对于一些 GIST 腹膜转移患者，长期伊马替尼治疗后有可能进行治愈性挽救性手术。
