甲磺酸伊马替尼新辅助治疗后成功切除巨大胃胃肠间质瘤。
A Giant Gastric Gastrointestinal Stromal Tumor Successfully Resected Following Neoadjuvant Treatment With Imatinib Mesylate.
机构信息
Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.
Department of Gastroenterological Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan
出版信息
Anticancer Res. 2020 Feb;40(2):1147-1152. doi: 10.21873/anticanres.14056.
BACKGROUND
Neoadjuvant treatment with imatinib mesylate (IM) has not been established for gastrointestinal stromal tumor (GIST). A case of a giant gastric GIST that was radically resected following neoadjuvant therapy with IM is reported.
CASE REPORT
A 71-year-old woman with abdominal distension was referred to our hospital for treatment. Contrast-enhanced computed tomography showed a large (>30 cm), heterogeneous mass, with dilated vessels around the tumor. The diagnosis was a gastric GIST by endoscopic ultrasound-fine needle aspiration, and neoadjuvant therapy with 400 mg IM daily was started. Radical surgery was performed after 13 months. Since the tumor was not invasive, complete resection by partial gastrectomy was achieved without the need for combined resection of other organs. The patient remains alive without recurrence 12 months after surgery.
CONCLUSION
A giant GIST, larger than 30 cm in size, is quite rare. Neoadjuvant IM treatment should be considered in the management of large GISTs.
背景
伊马替尼甲磺酸盐（IM）的新辅助治疗尚未确立用于胃肠道间质瘤（GIST）。报告了一例接受 IM 新辅助治疗后根治性切除的巨大胃 GIST 病例。
病例报告
一名 71 岁女性因腹胀就诊于我院。增强 CT 显示一个 >30cm 的大的、异质性肿块，肿瘤周围有扩张的血管。内镜超声引导下细针抽吸活检诊断为胃 GIST，开始每天服用 400mg IM 的新辅助治疗。13 个月后进行根治性手术。由于肿瘤没有浸润性，通过部分胃切除术实现了完全切除，而无需联合切除其他器官。术后 12 个月患者无复发，仍存活。
结论
大于 30cm 的巨大 GIST 非常罕见。对于大型 GIST，应考虑 IM 的新辅助治疗。
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