[A case of recurrent intestinal GIST with long-term survival-beneficial effect of multimodality therapy using high-dose imatinib and surgery].

Treatment of recurrent GIST is often difficult. Here, we report a case of recurrent intestinal GIST with long-term survival. A 67-year-old woman underwent surgical resection of a GIST of the jejunum. Recurrence was observed 2 years after the operation: a tumor was found in the abdominal wall and imatinib therapy was started at a daily dose of 400 mg. However, a new metastatic nodule was noted 2 months later. Because a duplication mutation in KIT exon 9 was found in the primary tumor, we decided to increase the dose of imatinib to 800 mg/day. The tumors presented with PR-SD thereafter. About 3 years after the first surgery, a new lesion was found. We assessed the tumor as resectable and performed resection. About 10 months after the second surgery, however, a new lesion was detected. Imanitib therapy was re-started at a dose of 800 mg/day, and the tumor has remained PR-SD to date. She continues to be an outpatient 7 years and 5 months after the first operation. The multimodality therapy of high-dose imatinib and surgery is beneficial for the control of recurrent intestinal GIST.