Sato Yoshihiro, Karasawa Hideaki, Aoki Takeshi, Imoto Hirofumi, Tanaka Naoki, Watanabe Kazuhiro, Abe Tomoya, Nagao Munenori, Ohnuma Shinobu, Musha Hiroaki, Takahashi Masanobu, Motoi Fuyuhiko, Naitoh Takeshi, Ishioka Chikashi, Unno Michiaki
Dept. of Surgery, Tohoku University Graduate School of Medicine.
Gan To Kagaku Ryoho. 2016 Nov;43(12):2216-2218.
We report a case of a huge gastric gastrointestinal stromal tumor(GIST)that was safely resected followingpreoperative imatinib therapy. A 72-year-old woman was hospitalized with severe abdominal distension. Computed tomography revealed a 27×17 cm tumor in the left upper abdominal cavity. The patient was diagnosed with high risk GIST by EUS-FNA. We initiated preoperative adjuvant chemotherapy with imatinib to achieve a reduction of operative risks and functional preservation. After 6 months of chemotherapy, CT showed a reduction in the tumor size and the patient underwent partial gastrectomy and partial resection of the diaphragm. Histologically, most of the tumor cells were replaced by hyalinized collagen and viable cells were scattered only around the blood vessels. Neoadjuvant chemotherapy with imatinib has the potential to become an important therapeutic option for the treatment of huge GISTs.
我们报告一例巨大胃胃肠道间质瘤(GIST)病例,该病例在术前接受伊马替尼治疗后成功切除。一名72岁女性因严重腹胀入院。计算机断层扫描显示左上腹腔有一个27×17 cm的肿瘤。通过超声内镜引导下细针穿刺活检(EUS-FNA),该患者被诊断为高危GIST。我们开始使用伊马替尼进行术前辅助化疗,以降低手术风险并保留功能。化疗6个月后,CT显示肿瘤大小减小,患者接受了部分胃切除术和膈肌部分切除术。组织学检查显示,大部分肿瘤细胞被透明化的胶原组织取代,仅在血管周围散在有存活细胞。伊马替尼新辅助化疗有可能成为治疗巨大GIST的重要治疗选择。