Inukai Michiko, Shibasaki Susumu, Suzuki Kazumitsu, Tsuru Yasuhiro, Matsuo Kazuhiro, Goto Ai, Nakamura Kenichi, Tanaka Tsuyoshi, Kikuchi Kenji, Suda Koichi, Inaba Kazuki, Uyama Ichiro
Dept. of Surgery, Fujita Health University School of Medicine.
Gan To Kagaku Ryoho. 2020 Dec;47(13):2062-2064.
A 55-year-old man complained of abdominal distention. Gastroscopy showed a submucosal tumor in the upper-third portion of the stomach, with a biopsy diagnosis of gastrointestinal stromal tumor(GIST). Because abdominal contrast- enhanced CT findings suspected the invasion of the tumor into the pancreatic tail, preoperative imatinib therapy was performed. After 2 weeks of treatment, the tumor had shrunk to 44% of its starting volume. Six months later, CT findings suggestive of the tumor invasion had disappeared. Therefore, the laparoscopic local resection of the stomach was performed. The postoperative course was uneventful. A pathological diagnosis was c-kit-positive GIST, with less than 5/50 HPF of mitotic counts. Imatinib was restarted 2 weeks after the operation. The patient is alive 8 months after the operation, with no obvious recurrence. Preoperative imatinib therapy can be a useful option for large GIST tumors.
一名55岁男性主诉腹胀。胃镜检查显示胃上三分之一处有一个黏膜下肿瘤，活检诊断为胃肠道间质瘤（GIST）。由于腹部增强CT检查结果怀疑肿瘤侵犯胰尾，因此进行了术前伊马替尼治疗。治疗2周后，肿瘤缩小至初始体积的44%。6个月后，提示肿瘤侵犯的CT检查结果消失。因此，进行了腹腔镜下胃局部切除术。术后过程顺利。病理诊断为c-kit阳性GIST，有丝分裂计数小于5/50 HPF。术后2周重新开始使用伊马替尼。患者术后8个月存活，无明显复发。术前伊马替尼治疗对于大型GIST肿瘤可能是一种有用的选择。
