A Case of Gastrointestinal Stromal Tumor with Metachronous Metastasis to the Liver

Yasuhiro Kouchi, Masatoshi Shigeta, Tomohiro Inokuchi, Shinobu Tomochika, Mitsuhiro Nakao, Yuji Fujita, Makoto Miyahara, Hidefumi Kubo, Hiroyasu Hasegawa and Hiroshi Miyashita

Department of Surgery, Social Insurance Tokuyama Central Hospital

A 61-years-old man was admitted to the hospital because of abdominal distention. Abdominal US, CT scan and MRI revealed a tumor in the right hypochondrium. Angiogram showed a hypervascular tumor feeding from left gastric artery. We suspected a leiomyosarcoma and performed an operation. A tumor 11×7×6 cm in size growing extraluminally from the poterior wal1 of the middle body of the stomach was observed. Partial resection of the stomach was performed. Histopathologically, spindle cells proliferated and mitosis was not observed with each high-power field. Immunohistochemical study showed that the tumor was positive for vimentin CD34, myogenic and neurogenic markers. Therefore, we diagnosed the tumor as a low grade malignant (GIST) of the stomach. Multiple hepatic metastasis occurred one year after the operation, and right hepatectomy was perfomed. The postoperative course was uneventful and he had no sign of recurrence for six months.

Key words
gastrointestinal stromal tumor

Reprint requests
Yasuhiro Kouchi Department of Surgery, Social Insurance Tokuyama Central Hopital 1-1 Kodacho, Tokuyama, 745-8522 JAPAN

Accepted
November 27, 2002

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