Kikuchi Daiki, Ishii Yoshimasa, Saitou Masaru, Yamada Mutsuo, Takenoshita Seiichi
Dept. of Surgery, Fukushima Medical School of Medicine, Japan.
Gan To Kagaku Ryoho. 2011 Jul;38(7):1201-4.
We report a case of a residual stomach gastrointestinal stromal tumor (GIST) successfully treated with resection. We were able to curatively resect after treatment with imatinib. A 33-year-old man underwent distal gastrectomy for duodenal ulcer perforation at the age of 18. He began to experience back pain, and the diagnosis of mild gastritis was made over observation in near medicine, but he was admitted to our hospital because his symptoms continued for 5 months. Abdominal CT and MRI showed a protruding lesion of approximately 17 cm in the left upper-abdomen. Surgery was performed, but the tumor had directly invaded the surrounding organs. To find the definite diagnosis, a biopsy was performed. The histopathological diagnosis was c-kit-positive GIST. Administration of imatinib 400 mg/day was commenced. After 6 months of treatment, CT revealed a roughly 68% reduction in the tumor's diameter. The radical operation was considered feasible and total gastrectomy was performed. The postoperative course was uneventful. Neoadjuvant therapy with imatinib may become a useful means of conserving improve organ and complete resection rate increase with tumor reduction.
我们报告一例残余胃胃肠道间质瘤(GIST)经手术切除成功治疗的病例。我们在使用伊马替尼治疗后能够进行根治性切除。一名33岁男性在18岁时因十二指肠溃疡穿孔接受了远端胃切除术。他开始出现背痛,在附近医院观察诊断为轻度胃炎,但由于症状持续5个月而入住我院。腹部CT和MRI显示左上腹有一个约17 cm的突出病变。进行了手术,但肿瘤已直接侵犯周围器官。为明确诊断,进行了活检。组织病理学诊断为c-kit阳性GIST。开始每天服用400 mg伊马替尼。治疗6个月后,CT显示肿瘤直径大致缩小了68%。考虑根治性手术可行,遂进行了全胃切除术。术后病程顺利。伊马替尼新辅助治疗可能成为一种有用的手段,可保留改善器官功能,并随着肿瘤缩小提高完整切除率。