Dhull A K, Kaushal V, Dhankhar R, Atri R, Singh H, Marwah N
Department of Radiation Oncology, PGIMS, P.O. Box 100, Rohtak 124001, India.
Case Rep Oncol Med. 2011;2011:985242. doi: 10.1155/2011/985242. Epub 2011 Jul 2.
Gastrointestinal stromal tumors (GISTs) are malignant and rare form of soft tissue sarcoma of the digestive tract. The incidence of gastrointestinal stromal tumors is very low Kramer et al. 2005 Jejunal GISTs are extremely rare. Here we present a rare case of jejunal GIST with unusually large size at presentation. The patient presented with severe abdomen pain, exophytic growth, and dimorphic anemia. Surgical resection of the tumor was carried out, and operative findings revealed a 15 × 10 cm growth, arising from serosal surface of jejunum, at the antimesenteric surface. Diagnosis in this case was made by subjecting the resected specimen to immunohistochemical analysis. In view of large size of the resected tumor, and high-risk histopathological features, imatinib mesylate 400 mg once daily was given as adjuvant chemotherapy. Patient is asymptomatic without any evidence of tumor recurrence after six months of postoperative followup. Imatinib as such is recommended in metastatic, residual or recurrent cases of GISTs or which are surgically not removable; however, recent recommendations suggests the use of imatinib mesylate after radical surgery in high-risk cases, because it has shown a significant decrease in the recurrence rate, and the Food and Drug Administration (FDA) has also approved the use of imatinib as adjuvant therapy after complete resection of localized, primary GIST.
胃肠道间质瘤（GISTs）是消化道软组织肉瘤中一种恶性且罕见的类型。胃肠道间质瘤的发病率非常低（Kramer等人，2005年）。空肠GIST极其罕见。在此，我们报告一例罕见的空肠GIST病例，其在初诊时体积异常大。该患者表现为严重腹痛、外生性生长和双相性贫血。对肿瘤进行了手术切除，手术所见显示在空肠浆膜面、系膜对侧有一个15×10厘米的肿物生长。通过对切除标本进行免疫组织化学分析做出了本例的诊断。鉴于切除肿瘤体积大且具有高危组织病理学特征，给予甲磺酸伊马替尼400毫克每日一次作为辅助化疗。术后随访6个月，患者无症状，无任何肿瘤复发迹象。伊马替尼本身推荐用于GIST的转移、残留或复发病例，或手术无法切除的病例；然而，最近的建议表明，在高危病例的根治性手术后使用甲磺酸伊马替尼，因为它已显示出复发率显著降低，并且美国食品药品监督管理局（FDA）也已批准在局部原发性GIST完全切除后使用伊马替尼作为辅助治疗。
