Kitamura Daisuke, Ikeda Koji, Unotoro Jo, Seki Eiichiro, Gonda Hirohumi, Izumi Hiroshi
Department of Surgery, Ota General Hospital.
Nihon Shokakibyo Gakkai Zasshi. 2013 Jan;110(1):74-80.
A 69-year-old man was admitted with difficulty in defecation and urination. CT showed a giant tumor connected with the rectum in the lower pelvic cavity, and also the presence of 4 smooth surfaced tumors, 3 of which were in the abdominal cavity, while the other one was in the left inguinal region. A core needle biopsy was performed in the left inguinal region indicated the presence of gastrointestinal stromal tumor (GIST), and we clinically diagnosed this case as having multiple metastatic rectal GISTs. The patient was treated with imatinib mesylate, and CT showed the size of the rectal GIST to have dramatically decreased, with only one metastatic tumor remaining in the abdominal cavity. Therefore, an abdominoperineal resection and metastasectomy were performed, and the tumors were completely excised. The patient is alive without recurrence at 18 months after surgery, while continuing to receive imatinib mesylate.
一名69岁男性因排便和排尿困难入院。CT显示盆腔下部有一个与直肠相连的巨大肿瘤，同时还有4个表面光滑的肿瘤，其中3个位于腹腔，另一个位于左侧腹股沟区。在左侧腹股沟区进行了粗针活检，结果显示为胃肠道间质瘤（GIST），我们临床诊断该病例为多发性转移性直肠GIST。患者接受甲磺酸伊马替尼治疗，CT显示直肠GIST的大小显著减小，腹腔内仅残留一个转移瘤。因此，进行了腹会阴联合切除术和转移瘤切除术，肿瘤被完全切除。患者术后18个月仍存活且无复发，同时继续接受甲磺酸伊马替尼治疗。
