[A case of giant gastric GIST with multiple hepatic metastases with long-term survival after multimodal therapy].

A male patient in his 40s presented with abdominal pain and mass palpitation. He was diagnosed with a submucosal gastric tumor and referred to our clinic. Computed topography (CT) scan revealed a large gastric tumor and multiple hepatic metastases. He was diagnosed with unresectable gastrointestinal stromal tumor (GIST) and began imatinib treatment. However, 2 weeks later, the patient developed a high fever and abdominal pain. Tumor necrosis and abscess formation was observed on the CT scan. We performed emergency surgery, which comprised partial gastrectomy, distal pancreatectomy, and splenectomy, combined with radiofrequency ablation (RFA) for the hepatic metastases. Subsequently, he continued imatinib therapy. However, a new lesion developed in the liver and was diagnosed as imatinib-resistant disease. The new lesion was treated with RFA. Eight years after the treatment, a new lesion occurred in the liver, which was difficult to excise owing to the location. Accordingly, a right-hepatic lobectomy was performed. Currently, he is alive and continues on imatinib therapy.