A Case of Postoperative Recurrence due to Gastrointestinal Stromal Tumor of the Stomach Responding to Imatinib Mesylate

Takayuki Suto, Yosho Emura, Noriyuki Uesugi^*, Tamotsu Sugai^*, Shin-ichi Nakamura^* and Kazuyoshi Saito^**

Department of Surgery, Morioka Municipal Hospital
^*Division of Pathology, Central Clinical Laboratory, School of Medicine, Iwate Medical University
^**Department of Surgery I, School of Medicine, Iwate Medical University

We report a case of a postoperative recurrence of a gastrointestinal stromal tumor (GIST) of the stomach that responded to the administration of imanitib mesylate. A 77-year-old woman who had been hospitalized because of epigastric discomfort was referred to us for the treatment of a submucosal tumor of the cardia that was detected during a gastroscopy examination. The patient underwent a total gastrectomy and splenectomy on June 11, 2001 after being diagnosed as having a gastrointestinal mesenchymal tumor of the stomach. Histopathologically, the tumor was composed of a fascicular proliferation of spindle-shaped cells with marked mitosis. Immunohistochemically, the tumor cells were positive for c-kit and CD34 but negative for actin and s-100. The tumor was diagnosed as a malignant GIST. She was latter readmitted for nausea. A CT examination showed multiple liver metastasis and subphrenic tumors. Treatment with imanitib mesylate at a dose of 400 mg/day for 16 days was initiated on June 25, 2002. This dosage was reduced to 200 mg/day on July 12, 2002, because of nausea. A CT scan showed rapid tumor shrinkage and cystic changes after 74 days of treatment, the response has continued to date. All toxicities were mild and tolerable. This case suggests that the administration of imanitib mesylate may be an effective treatment for GIST recurrences.

Key words
imatinib mesylate, gastrointestinal stromal tumor, liver metastasis

Reprint requests
Takayuki Suto Department of Surgery, Morioka Municipal Hospital 15-1 Koyashiki, Motomiya, Morioka, 020-0866 JAPAN

Accepted
April 30, 2003

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