Department of Gastroenterology, National Hospital Organization Takasaki General Medical Center, 36 Takamatsu-cho, Takasaki, Gunma, 370-0829, Japan.
Nutrition Support Team, National Hospital Organization Takasaki General Medical Center, 36 Takamatsu-cho, Takasaki, Gunma, 370-0829, Japan.
Clin J Gastroenterol. 2021 Apr;14(2):570-576. doi: 10.1007/s12328-021-01340-7. Epub 2021 Jan 28.
It is very difficult to treat patients with liver metastasis presenting with jaundice or cachexia. We herein report a successfully treated case of huge liver metastasis of gastrointestinal stromal tumor (GIST) that initially showed jaundice and cachexia. The patient was a woman in her early 40 s. She had a history of duodenal GIST 4 years before this admission. She was admitted to our hospital for abdominal fullness and anorexia. Abdominal computed tomography revealed huge liver metastasis of GIST. She showed jaundice and cancer cachexia with a modified Glasgow Prognostic Score of 2. After applying nutritional support, 400 mg of imatinib was administered. Although leg edema transiently worsened, the withdrawal of imatinib and administration of diuretics improved it. Imatinib was re-administered, and nutritional support was continued. The total bilirubin level decreased, and the serum albumin level increased. The tumor gradually decreased in size. Finally, she received surgical resection after 16 months of treatment with imatinib. Although adjuvant imatinib administration was continued after surgery, and no recurrence was observed as of 18 months after surgery.
对于伴有黄疸或恶病质的肝转移患者，治疗非常困难。我们在此报告了一例胃肠道间质瘤（GIST）巨大肝转移的成功治疗病例，该患者最初表现为黄疸和恶病质。患者为 40 岁出头的女性，在本次入院前 4 年患有十二指肠 GIST。她因腹胀和食欲不振而入院。腹部计算机断层扫描显示 GIST 有巨大的肝转移。她出现黄疸和癌性恶病质，改良格拉斯哥预后评分 2 分。给予营养支持后，给予 400mg 伊马替尼。虽然下肢水肿短暂恶化，但停用伊马替尼和使用利尿剂后得到改善。重新给予伊马替尼，并继续给予营养支持。总胆红素水平下降，血清白蛋白水平升高。肿瘤逐渐缩小。最终，在接受伊马替尼治疗 16 个月后，她接受了手术切除。手术后继续辅助伊马替尼治疗，截至术后 18 个月，未观察到复发。
