Gomi Kuniyuki, Mihara Motohiro, Abe Mitsutoshi, Ikeda Yoshiaki, Shimada Kou, Maruyama Kiyotomi, Kajikawa Shoji, Shirota Hiroshi
Dept. of Surgery, Suwa Red Cross Hospital.
Gan To Kagaku Ryoho. 2014 Jan;41(1):103-6.
An 89-year-old male patient was found to have a mass with a diameter of 54 mm in the pelvic cavity, connected to the rectum, and was diagnosed with a gastrointestinal stromal tumor (GIST)of the rectum by transrectal biopsy. The patient was treated continuously with 400mg/day of imatinib mesylate with no significant adverse events, and the tumor gradually reduced in size. The tumor reduced in size to a diameter of 24 mm at 57 months post-treatment, and a partial response has been maintained for 60 months. Colorectal GIST is rare, comprising 5% of all GIST cases, and surgical resection is the first choice of treatment. In this case, due to a lack of consent, we chose imatinib mesylate as the treatment. However, imatinib mesylate has been reported to induce adverse events more frequently in older patients, and thus we took care to reduce the treatment dosage. We report this case to highlight that a normal quantity of imatinib mesylate can be administered, with no significant adverse events.
一名89岁男性患者被发现盆腔内有一个直径54毫米的肿块，与直肠相连，经直肠活检诊断为直肠胃肠道间质瘤（GIST）。该患者接受每日400毫克甲磺酸伊马替尼持续治疗，未出现明显不良事件，肿瘤逐渐缩小。治疗后57个月时，肿瘤直径缩小至24毫米，部分缓解状态已维持60个月。结直肠GIST较为罕见，占所有GIST病例的5%，手术切除是首选治疗方法。在此病例中，由于患者未同意手术，我们选择甲磺酸伊马替尼作为治疗手段。然而，据报道甲磺酸伊马替尼在老年患者中更常引发不良事件，因此我们注意降低了治疗剂量。我们报告此病例以强调可以给予正常剂量的甲磺酸伊马替尼，且无明显不良事件。
