A Case of Gastrointestinal Stromal Tumor of the Small Intestine with Peritoneal Dissemination Effectively Treated with Chemotherapy

Manabu Takano, Kaname Ono, Osamu Miyamoto, Hiroto Akiyama and Kenichi Iida^*

Department of Surgery, Department of Pathology^*, Inazawa City Hospital

We report a case of gastrointestinal stromal tumor (GIST) of the small intestine with peritoneal dissemination effectively treated with chemotherapy in a 54-year-old woman presenting with upper abdominal pain. She was admitted for tumor mass in the right lower abdomen. Abdominal ultrasound (US) and postcontrast computed tomography (CT) showed multiple masses but no upper lower gastrointestinal images. Preoperative diagnosis was a mesenteric tumor. Laparotomy revealed main tumor was located at the ileum and dissemination to the peritoneal wall was observed. Pathological examination showed dense fascicular proliferation of spindle tumor cells in a bundle. Since immunohistochemical studies revealed tumor cells with a positive for vimentin and Kit, and a negative for α-SMA, S-100 protein, and CD34, we diagnosed GIST, derived from the Cajal cell that generates the pacemaker component of the gut and plays important roles in the control of gut motility. She received modified adjuvant CYVADIC chemotherapy after initial surgery and a twenty one-month disease free period was obtained. We also review the literature.

Key words
gastrointesitnal stromal tumor, pacemaker cell tumor, Cajal cell

Reprint requests
Manabu Takano Department of Surgery, Daido Hospital
9 Hakusui-cho, Minami-ku, Nagoya, 457-8511 JAPAN

Accepted
March 27, 2002

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